Objective To evaluate the reasons for intrathecal administration of vincristine,the characteristics of patients with nerve damage,and the effective rescue measures and outcome prognosis.Methods Electronic literature databases,English and Chinese Paper Documents databases,and Network Engine were searched for Case Reports of inadvertent intrathecal injection of vincristine.SPSS 15.0 was used for statistical analysis.Results Analysis of 32 cases report showed that the intrathecal injection of vincristine in patients had adverse outcome.Of these cases 25 led to death,and survival of cases was associated with lower limb paralysis or quadriplegia.Fatalities appeared due to a progressively ascending myeloencephalopathy.Early recognition and immediate treatment with CSF drainage appeared to be the only intervention that had improved patients' survival.The survival curves of different surgical treatments,whether or not to use folic acid treatment,whether or not to use glutamate treatment,whether or not to use pyridoxinetreatment,was a significant difference.Conclusions Timely ventriculo-lumbar washout,using folic acid treatment and glutamate treatment appear critical.It is difficult to obtain satisfactory clinical outcome,so the key lies in the implementation of effective preventive measures.

Purpose :To study the effect of bFGF on the idiopathic oligoasthenospermia. Methods:bFGF wasused for 34 patients with idiopathic oligoasthenospermia in the male infertility. The immunohistochemical tech-nique, radioimmunoassay, electromicroscope technique and semen quality analysis were used to investigate thestructure and function of testile of patients. Results: bFGF could promote the proliferation of spermatogenouscells, improve arrangement of cells and ultrastructure of testile. All patients semen were improved. Sexual hor-mones (PRL, FSH, LH, T) in serum araised. The ability of reproduction of patients was increased consequent-ly. Conclusions:bFGF is an effective drug for patients with idiopathic oligoasthenospermia in the male infertility.

Objective To build a high sensitive method to detect HIV-1 P24 antigen quantitatively by Immuno-rotary Biosensor (IRB) based on F0F1-ATPase. Methods The immuno-rotary biosensor based on F0F1-ATPase in chromatophores for detecting HIV-1 P24 was assembled by label F0F1-ATPase chromatophores with the biotin-labled HIV-1 P24 antibody through the streptavidin-biotin-β antibody and the pH sensitivity of fluorescence F1300. Then it's sensitivity and specificity was tested by the prokaryotic expressed HIV-1 P24 antigen. Results Immuno-rotary biosensor based on F0F1-ATPase in chromatophores can detect P24 antigen sensitivily, the lowest level that could be detected was 0.1 fg/ml. Conclusion IRBbased system was successfully assembled and used for the detection of P24 antigen, the rapid and sensitive technique will be useful for detecting HIV-1 P24 antigen quantitatively.

OBJECTIVEOne of the important reasons for male infertility is asthenozoospermia, for which there is no specific cure for the time being. The authors explored the clinical effect of L-carnitine for infertile males with asthenozoospermia.

METHODSA total of 135 patients with asthenozoospermia were randomly divided into Groups A (n = 68) and B (n = 67), the former treated with L-carnitine (2 g/d) and vitamin E, while the latter with vitamin E only, both for 3 months. All the patients received semen analyses before and after the treatment, and were observed for adverse effects. The pregnancy rates of their wives were recorded.

RESULTSGroup A showed a significantly increased percentage of forward motile sperm after the treatment (45.4% +/- 11.1%) as compared with pretreatment (28.6% +/- 9.2%) (P < 0.01), but no statistically significant differences were found in sperm density and the percentage of the sperm of normal morphology (P > 0.05). The rate of pregnancy was significantly higher in Group A (31.1%) than in B (3.8%) after the treatment (P < 0.01). No adverse events were found during the treatment.

CONCLUSIONL-carnitine, capable of significantly improving sperm motility and raising the rate of pregnancy, is a safe and effective therapeutic option for asthenozoospermia.

Adult ; Asthenozoospermia ; drug therapy ; Carnitine ; therapeutic use ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Sperm Motility ; drug effects ; Treatment Outcome ; Vitamin E ; therapeutic use ; Young Adult

BACKGROUNDPituitary adenomas are common intracranial tumors, with a rising incidence in China. Excision is a mainstay therapy for this disease, and is often carried out via transfrontal, transsphenoidal or transpterional approaches. However, few studies have systematically addressed the regional anatomy involved in these microsurgical procedures. The present study attempted to establish some key anatomic measurements relevant to pituitary adenoma resection based on cadaver and computer tomography (CT) image studies.

METHODSHead specimens from 30 randomly selected formalin-fixed adult cadavers were used for anatomical analysis. Measurements were made on the base of the skull following removal of brain structures above the pituitary gland, and on the mid-sagittal plane of the cranium. Parameters were designed by considering the 3 above-mentioned common microsurgical approaches, and obtained on each head using a sliding caliper. Multi-level CT images from 30 individuals were also used for distance measurements between landmark structures that are relevant to these surgeries. All data were subjected to statistical analysis using the SPSS 11.5 software.

RESULTSThere was statistically significant difference (P < 0.05) of distance measured on cadavers relative to CT images in 3 sets of measurements related to the transfrontal surgical approach, i.e., distances from the midpoint of superciliary arch superior border to the cranial entrance of internal carotid arteries (ICAs), the opposite side entrance of ICA and to the genu of ICA. While regional anatomical analyses were carried out according to the transpterional approach, statistically significant difference was also found in 3 sets of distance measurements between cadaver and CT image data, with regard to the distances between the pterion and some landmark structures around the pituitary.

CONCLUSIONSThe present study provides key anatomical and CT image measurements involving the 3 conventionally used surgical approaches for pituitary tumor resection. The data implicate that while CT scan results can provide valuable guidelines for operations, cautions and adjustments are needed during surgery for sufficient tumor excision and protection of key blood vessels and nerves in the vicinity of the pituitary gland and around the surgical pathway.

Adult ; Female ; Humans ; Male ; Pituitary Gland ; anatomy & histology ; diagnostic imaging ; Pituitary Neoplasms ; diagnostic imaging ; surgery ; Radiography

OBJECTIVETo study the variation of specific antibody among convalescent of severe acute respiratory syndrome (SARS) patients through a three-year program.

METHODSSera samples were collected from SARS cases in the 5th, 20th and 35th month after onset of the illness. The SARS-CoV specific antibody was detected for all of them by ELISA and neutralized test simultaneously. The titer of neutralizing antibodies was calculated using Reed-Muench method, and the comparison between different time groups was analyzed regarding the variance of data on repeated measures after logarithm conversion.

RESULTS13, 17 and 13 sera samples were collected in the 5th, 20th and 35th month after onset. Results showed that despite the fact that the positive rates of ELISA antibody were 100%, 82.4% and 84.6% respectively,the neutralizing antibody was still positive for all the samples. The average neutralizing antibody titers were 1:43 (1:16-1:203), 1:36 (1:17-1:59) and 1:21 (1:10-1:39) on the 5th, 20th and 35th month after onset, and the differences were statistically significant (F = 60.419, P < 0.001). On the 35th month after the onset, 30.8% (4/13) of the patients were still having the neutralizing antibody level of above 1:36, but the neutralizing antibody level in another 30.8% (4/13) of the patients had decreased to as low as 1:10, when the cut-off level was set as 1:8.

CONCLUSIONResults of the study indicated that the neutralizing antibody of SARS cases could last for at least three years, but the sera specific antibody in SARS cases decreased gradually when time went by. However, neutralizing antibody in some of the cases decreased to a lower level on the 35th month. Further follow-up study was worthwhile to observe the long-lasting profile of antibody existence on SARS cases.

Antibodies, Neutralizing ; analysis ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Humans ; Severe Acute Respiratory Syndrome ; immunology

BACKGROUNDSevere acute respiratory syndrome coronavirus (SARS-CoV) is a newly emerging virus that gives rise to SARS patients with high rates of infectivity and fatality. To study the humoral immune responses to SARS-CoV, the authors evaluated IgG and IgM specific antibodies in patients' sera.

METHODSTwo methods, enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescent assay (IFA), were used to detect specific serum IgG and IgM against SARS-CoV in 98 SARS patients and 250 controls consisting of patients with pneumonia, health-care professionals and healthy subjects. The serum antibody profiles were investigated at different times over one and a half years in 18 of the SARS patients.

RESULTSThe sensitivity and specificity of ELISA for detecting IgG against SARS-CoV were 100.0% and 97.2% and for IgM 89.8% and 97.6% respectively; the figures using IFA for IgG were 100.0% and 100.0% and for IgM 81.8% and 100.0% respectively. During the first seven days of the antibodies trace test, no IgG and IgM were detected, but on day 15, IgG response increased dramatically, reaching a peak on day 60, remaining high up to day 180 and decreasing gradually until day 540. On day 15, IgM was detected, rapidly reached a peak, then declined gradually until day 180 when IgM was undetectable.

CONCLUSIONThe detection of antibodies against SARS virus is helpful in the clinical diagnosis of SARS.

Adult ; Aged ; Antibodies, Viral ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Male ; Middle Aged ; SARS Virus ; immunology ; Severe Acute Respiratory Syndrome ; immunology ; T-Lymphocytes, Cytotoxic ; immunology

OBJECTIVETo distinguish the edema, injury, or rupture in the traumatic skeletal muscle fiber in vivo using diffusion tensor imaging (DTI) and tractography on magnetic resonance imaging (MRI).

METHODSThe skeletal muscle trauma models were made in 4 rabbits (eight hindlimbs) by iron discus (weight 1.0 kg, diameter 6 cm) falling down vertically from 45 cm height to rabbits' thighs. Conventional sequences and two-dimensional (2D) diffusion-weighted (DW) spin-echo (SE) echo planar imaging (EPI) sequence with fat suppression (b = 600 s/mm2) were performed on 1. 5T MRI scanner. The grading of edema, injury, and fiber rupture in the damaged muscle were made according to their histopathological views, which was consistent with the images. The mean apparent diffusion coefficient (ADC) values and fractional anisotropy (FA) values were measured from the region of interests (ROIs) of all groups on 2D DW images used for tractography. Analysis of variance test was performed to analyze all data.

RESULTSADC values of the areas in normal muscle, edema muscle, injury muscle, and ruptured muscle were (6.12 +/- 1.34) x 10(-3), (6.38 +/- 1.30) x 10(-3), (8.06 +/- 0.97) x 10(-3), and (9.57 +/- 0.93) x 10(-3) mm2/s, respectively. There was significant difference among groups (P < 0.001), but no difference between edema muscle and normal muscle group (P > 0.05). The FA values of normal muscle, edema muscle, injury muscle, and ruptured muscle were 0.42 +/- 0.12, 0.36 +/- 0.12, 0.26 +/- 0.09, 0.12 +/- 0.08, respectively, with a significant difference among groups (P < 0.001). In the edema muscle, the tracking cross-fiber could be seen but it decreased slightly. In the injury muscle, the tracking fiber decreased markedly. In the ruptured muscle, the transverse-orientation tracking fiber vanished, yet some interrupted longitudinal-orientation tracking fiber could be found.

CONCLUSIONThe edema, injury, and rupture of muscle fiber in rabbit damaged skeletal muscle can be verified according to the ADC and the FA on DTI and tractography.

Animals ; Anisotropy ; Diffusion Magnetic Resonance Imaging ; methods ; Echo-Planar Imaging ; Edema ; diagnosis ; pathology ; Male ; Muscle, Skeletal ; injuries ; pathology ; Rabbits ; Rupture ; diagnosis ; pathology ; Thigh ; injuries ; pathology

OBJECTIVETo study the etiology and preventive measures of the long-term postoperative complication after esophageal replacement with colon for esophageal benign disease.

METHODSTo review the clinical data of 577 patients with esophageal replacement with colon our department, including 123 cases of esophageal benign disease. Of all, there were 25 cases-time for 11 cases following with severe complication: redundancy and dilated colon 12 cases-time, severe stricture of stoma 4, macrocyst esophagus 2, colon-stomach stoma expansion 4, mechanical obstruction of colon 3. The etiology included iatrogenic and functionality. The therapy included stricture form or resection, redundancy segment resection, obstructed segment solution and stoma resection and form.

RESULTSEight cases underwent once operation, 2 case twice, 1 case three times. After operation, 9 cases took food normally, 2 improved symptoms obviously.

CONCLUSIONSThe iatrogenic and functionality factor contributed to severe complication after esophageal replacement with colon for esophageal benign disease. The preventive measure is followed during operation: cervical esophageal-colon anastomosis exceed 2.5 centimeter, abdominal colon-stomach anastomosis reflux, channel width of colon passage, intestinal canal lay up straight. Re-operation is best choice to for local stricture, colon expansion, redundancy and dilated colon.

Adult ; Colon ; surgery ; Esophageal Diseases ; surgery ; Esophagoplasty ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; surgery ; Reoperation ; Retrospective Studies

Objective To explore the demographic characteristics and clinical features of patients with idiopathic pulmonary arterial hypertension ( IPAH ) in China.Methods Between March 2007 and September 2010,IPAH diagnosis was confirmed by right heart catheterization in 150 adult patients from 31 clinical centers in China.Clinical and hemodynamic data were analyzed and patients were divided into WHO functional class Ⅰ / Ⅱ and WHO functional class Ⅲ/Ⅳ group.Results The mean age of 150 patients were 36 ± 13 years with female patient/male patient ratio of 2∶1,and mean BMI was ( 21.3 ± 3.5 ) kg/m2.Fatigue (n =123,82.0％ ) and dyspnea ( n =112,74.7％ ) are the most common symptoms.Accentuated pulmonic second sound ( P2 ) was detected in 92.0％ ( n =138 ) of patients during physical examination,which was also the most common sign.About 49.0％ ( n =73 ) patients were WHO functional class Ⅰ/ Ⅱ patients and 46.0％ ( n =68 ) patients were WHO functional class Ⅲ/Ⅳ patients. Six minutes walking distance (6MWD) and Borg dyspnea score was (337 ± 101 ) m and 2.0 (2.0,4.0),respectively.Right ventricular hypertrophy was suggested by ECG in 93.1％ ( n =140 ) patients.Right atrial pressure was (10 ±6) mm Hg,mean pulmonary artery pressure was (61 ±16) mm Hg,cardiac index was (2.3 ±0.8)L · min-1 · m-2 and pulmonary vascular resistance(1484 ±699) dyn · s-1 · cm-5 in this cohort.6 MWD (305 m ±89 m vs.377 m ±88 m) was significantly shorter while Borg dyspnea score [3.0 (3.0,5.0) vs.2.0 (2.0,3.0) ] was significantly higher in WHO functional class Ⅲ/Ⅳ patients than in WHO functional class Ⅰ/Ⅱ patients. Similarly hemodynamic parameters were also worse in WHO functional class Ⅲ/Ⅳ patients than in WHO functional class Ⅰ / Ⅱ patients ( all P ＜ 0.05).Conclusion Idiopathic pulmonary arterial hypertension patients in this cohort affect mostly young adults,dominated by female gender and lower body mass index. Fatigue and dyspnea are the most common symptoms and accentuated pulmonic second sound ( P2 ) is the most common sign.IPAH patients are often displaying severe functional and hemodynamic disturbance at first visit to hospitals.Dyspnea and hemodynamic impairment are related to 6MWD and WHO functional class.