Objective To propose a new blood purification modality-hemodialysis with plasma- based dialysate (HD-PBD) plus high volume hemofiltration (HVHF) for patients with liver failure, and to evaluate the effect of this treatment on plasma cytokines.Methods Twelve patients with liver failure were included in this study.All patients received HD-PBD therapy in the first 6 hours,and then were treated with HVHF for 24 hours with the same filter (AV600).The levels of TNF-?,IL-1?, IL-6 and IL-8 in plasma before and after HD-PBD plus HVHF for 6 and 24 hours were examined respectively by ELISA,and changes of clinical parameters were observed at the same time point. Serum bilirubin,total bile acids (TBA),serum ammonia,blood urea nitrogen (BUN) and serum creatinine (Scr) were detected before and after treatment.Arterial blood gas analysis and the concentration of electrolytes were monitored before and after treatment.Results (1)HD-PBD for 6 hours was more effective than HVHF for 24 hours in removal of serum bilirubin and TBA(P＜0.05). (2)Serum ammonia,BUN,Ser,arterial blood HCO_3~-,PCO_2,PO_2 and electrolytes did not show significant difference before and after HD-PBD (P＞0.05),but these parameters significantly changed before and after HVHF (P＜0.05).(3)The average level of serum bilirubin was sharply decreased after HVHF for 24 h following HD-PBD(P＜0.05).(4)After HD-PBD plus HVHF,there was a marked reduction of the plasma levels of TNF-?,IL-6 and IL-8.Conclusions HD-PBD plus HVHF,a newly proposed modality for patients with liver failure,can effectively decrease serum bilirubin,TBA,BUN,Scr,ammonia and cytokines,and adjust water-electrolyte as well as acid- alkali balance.It is a low-cost,safe,simple and convenient therapy.

OBJECTIVETo determine the efficacy and feasibility of the combination of postural reduction and percutaneous kyphoplasty for traumatic thoracolumbar spine fractures.

METHODSThirty-seven patients with single level traumatic thoracolumbar spine fractures were included in this study. There are 28 males and 9 females, with an average age of 48 years (range 24 to 79 years). Patients were treated with postural reduction and then percutaneous vertebroplasty with Calcium Phosphate Cement (CPC) were performed on the fractured vertebra. The results were quantitatively evaluated, according to the concept of estimated vertebral height loss and kyphotic angle of the vertebral fractures by preoperative and postoperative plain standing lateral radiographs. Visual analog scale (VAS) and the fracture vertebra shape changes were recorded.

RESULTSPatients were followed up for 9 to 24 months (average 13 months), pain was significantly relieved compared with the preoperative, VAS was reduced averagely from 7.6 +/- 2.5 to 1.8 +/- 1.5, the anterior and middle vertebral height was restored and kyphotic angle was corrected. During the period of follow up, outcomes were satisfactory, without notable correction loss.

CONCLUSIONIf the indications are correctly handled, the combination of postural reduction and percutaneous kyphoplasty for the treatment of traumatic thoracolumbar spine fractures can provide significant pain relieve and restore the vertebral height and kyphotic angle.

Adult ; Aged ; Feasibility Studies ; Female ; Follow-Up Studies ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Posture ; Spinal Injuries ; surgery ; therapy ; Treatment Outcome ; Vertebroplasty ; methods

Objective To investigate the feasibility of 18G trocar for central venous catheterization in adults.Methods Retrospective analyzed the clinical data of 60 patients with central venous catheterization under local anesthesia.These patients were randomly divided into the control group and the observation group.Selected the internal jugular vein as the site of the puncture catheter.The control group was punc-tured by conventional puncture needle while the observation group was punctured by the 18G trocar.Results There was no statistical differ-ence between the two groups in the success rate of final puncture and catheterization(P>0.05).Compared with the control group,the suc-cess rate of guidewire insert was higher,the puncture operation time was shorter,the pain score during puncture operation was lower,and post-operative patient satisfaction was higher in the observation group.The differences of the two groups were statistically significant(P<0.05). Conclusion 18G trocar can perform central venous catheterization successfully.This method has great advantages for awake patients,and it also worked in some cases with difficult wire insertion.

OBJECTIVETo observe the effects of carboxymethyl chitosan calcium (CCC) on concentration of lead, calcium and zinc, and the liver antioxidative capacity in lead poisoned mice.

METHODSMice were randomly divided into 7 groups, including normal group, calcium carbonate group, lead-model group, and three experimental groups treated with CCC in three different doses, and the CaNa2EDTA positive control group. The lead poisoned mice model was established by giving water contained with lead acetate. CCC was administrated to mice i.g. once a day. Thirty days later, mice were killed and the concentrations of lead, calcium and zinc in blood, liver, brain and femur were determined by atomic absorption spectrophotometer. Maleic dialdehyde (MDA), total antioxidative capacity (T-AOC), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities in liver were measured by using assay kit.

RESULTSCCC significantly reduced the concentration of lead in blood, brain, liver and femur from about 1.56 microg/g, 13.38 microg/g, 16.15 microg/g, 1011.62 microg/g to about 0.50 microg/g, 5.57microg/g, 5.64 microg/g, 457.86 microg/g, and markedly increased the concentration of calcium in femur in lead poisoned mice. CCC had no significant side-effects on concentration of zinc in lead poisoned mice. The antioxidative profile was favorably changed as manifested by decreasing the level of MDA, increasing the activities of SOD, GSH-Px and T-AOC in livers of the in lead poisoned mice.

CONCLUSIONCCC might significantly advance the excretion of lead, increase the concentration of calcium in femur and the antioxidative capacity in lead-loaded mice.

Animals ; Brain Chemistry ; Calcium ; metabolism ; Chitosan ; analogs & derivatives ; pharmacology ; Female ; Femur ; chemistry ; Lead ; metabolism ; Lead Poisoning ; metabolism ; Liver ; chemistry ; Mice ; Mice, Inbred Strains ; Zinc ; metabolism

OBJECTIVETo compare therapeutic effects of different needling methods at Tiaokou (ST 38) on periarthritis of shoulder.

METHODSEighty cases of periarphritis of shoulder were randomly assigned to four groups. Tiaokou (ST 38) was selected in all the 4 groups. The treatment group were treated with penetration needling, and the control group A, B, C were treated by needling into 40 mm deep, needling into the subcutaneous tissue, sham acupuncture, respectively. Therapeutic effect was evaluated by Constant-Murley shoulder joint scale.

RESULTSThe clinical effective rate was 100.0% in the treatment group and 68.4% in the control group A, 52.6% in the control group B, 38.0% in the control group C with significant differences as the treatment group compared with the control groups A, B, C (P < 0.05 or P < 0.01). And with no significant difference as the control group A compared with the control group B, C, and the group B with the group C (P > 0.05).

CONCLUSIONDifferent needling depths of Tiaokou (ST 38) have different therapeutic effects, the penetration needling being the best and the sham needling being worse which can be used as control method.

Acupuncture Therapy ; Humans ; Periarthritis ; therapy ; Shoulder ; Shoulder Joint ; Shoulder Pain ; therapy

OBJECTIVETo investigate the effect of operative treatment for anteromedial facet fracture of the coronoid process of ulna,and to study its surgical exposures and fixation techniques.

METHODSFrom March 2005 to March 2010,18 patients with anteromedial facet fracture of the coronoid process of ulna were treated with open reduction and internal fixation. There were 12 males and 6 females with an average age of 37.8 years. A single midline posterior incision was used to expose the entire elbow joint. After elevating the full-thickness skin flaps, a lateral incision was made to expose and repair the lateral collateral ligament. Three intervals in the flexor-pronator musculature were used to gain access to the coronoid,depending on the size of the fracture fragment and the planned fixation technique. Fractures were fixed by using mini-plate or with screws. The therapeutic effects were evaluated by Mayo Elbow Performance Score (MEPS) and system of Broberg & Morrey.

RESULTSSeventeen patients were followed up, no patient complained pain and elbow unstable at a mean follow-up period of 38 months(1 to 6 years). The fractures were clinically healed at an average time of 11.6 weeks(ranged from 8 to 16 weeks). The average MEPS was 95.4+/-4.6 (ranged, 82 to 100). The average functional rating of system of Broberg & Morrey was 92.3+/-5.8 (ranged,75 to 100).

CONCLUSIONOpen reduction and internal fixation is effective to reach anatomical reduction and strong fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Ulna Fractures ; physiopathology ; surgery

To effectively guarantee quality of randomized controlld trial (RCT) of acupuncture and develop reasonable content and checklist of on-site quality control, influencing factors on quality of acupuncture RCT are analyzed and scientificity of quality control content and feasibility of on-site manipulation are put into overall consideration. Based on content and checklist of on-site quality control in National 11th Five-Year Plan Project Optimization of Comprehensive Treatment Plan for TCM in Prevention and Treatment of Serious Disease and Clinical Assessment on Generic Technology and Quality Control Research, it is proposed that on-site quality control of acupuncture RCT should be conducted with PICOST (patient, intervention, comparison, out come, site and time) as core, especially on quality control of interveners' skills and outcome assessment of blinding, and checklist of on-site quality control is developed to provide references for undertaking groups of the project.
Acupuncture Therapy ; standards ; China ; Humans ; Quality Control ; Randomized Controlled Trials as Topic ; standards ; Research Design ; standards

BACKGROUNDPrimary open-angle glaucoma (POAG) is characterized by optic nerve damage and consists of a group of genetically heterogeneous disorders. This study was to investigate the associations of genetic and environmental factors with POAG in a hospital-based Chinese population.

METHODSThirty-two adult onset POAG patients and 96 age-sex matched control subjects were studied by multivariable logistic regression analysis for the relationships between POAG and its risk factors including family history, diabetes, hypertension, cardiovascular diseases, cigarette smoking, alcohol consumption and polymorphisms of the myocilin and the optineurin genes.

RESULTSUnivariate analysis showed that POAG was related to family history, cardiovascular disease, alcohol consumption and a myocilin sequence alteration (T353I) (P < 0.04). Multivariable logistic regression analysis confirmed that POAG was significantly associated with family history (OR = 20.2), hypertension (OR = 3.58), cigarette smoking (OR = 10.8), alcohol consumption (OR = 0.028) and T353I (OR = 6.03, all P < 0.05).

CONCLUSIONSFamily history, hypertension, cigarette smoking and T353I in the myocilin gene are risk factors for POAG. Alcohol consumption, however, has a protective effect.

Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; adverse effects ; Cytoskeletal Proteins ; Eye Proteins ; genetics ; Female ; Glaucoma, Open-Angle ; etiology ; genetics ; Glycoproteins ; genetics ; Humans ; Hypertension ; complications ; Logistic Models ; Male ; Middle Aged ; Risk Factors ; Smoking ; adverse effects

OBJECTIVETo assess the protective effect of drinking green tea on the development of gastric, liver and esophageal cancers.

METHODSA population based study was conducted in Taixing, Jiangsu province, including 206, 204, 218 cases, respectively, and 415 population controls.

RESULTSGreen tea decreased the development of gastric cancer risk by 40%. Dose-response relationships were observed between the length of time, concentration and quantity of green tea drinking and its protective effects on gastric cancer. For individuals who drink green tea for more than 250 g per month, the risk of gastric cancer reduced about 60%. Green tea might have protective effect on liver cancer. However, no protective effect of green tea was observed on esophageal cancer.

CONCLUSIONGreen tea drinking might be a protective factor for gastric cancer. However, the protective effects of green tea on liver and esophageal cancer were not obvious.

Dose-Response Relationship, Drug ; Esophageal Neoplasms ; prevention & control ; Humans ; Liver Neoplasms ; prevention & control ; Plant Extracts ; therapeutic use ; Stomach Neoplasms ; prevention & control ; Tea ; chemistry

Based on the optimum clinical evidence, consulting the international guide, the outstanding guidelines of acupuncture clinical practices is formulated in order to promote the process of acupuncture modernization and internationalization. According to consensus of experts, using the questionnaire method, integrating the characteristics and requirements for acupuncture clinical practices, the guidelines reflect the characteristics of acupuncture, for instance, applicability, inheritance, holism, and the discipline characteristics. Thus, the guidelines will standardize the treatments in acupuncture clinical practices, strengthen medical service quality management, control medical costs, and promote the process of acupuncture modernization and internationalization.
Acupuncture Therapy ; standards ; Humans ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; standards