Acquired Immunodeficiency Syndrome ; immunology ; Adolescent ; Chemokines ; immunology ; Child ; Child, Preschool ; Female ; Humans ; Male

Acute paraplegia is a rare presentation for a spinal cord ependymoma. Subarachnoid hemorrhage (SAH) due to spinal ependymoma is also very rare. We report a 32-year-old woman who presented with acute paraplegia and typical clinical signs of SAH with normal cerebral angiography, and further diagnostic work-up revealed an spinal cord ependymoma as the source of the hemorrhage. There is evidence that some spinal cord ependymomas have intratumoral hemorrhage, but most of these bleedings occur without symptoms. We discuss the clinical and neuroradiological findings of this rare case and review the literature related to this unusual presentation.431

Objective:To analyze the job preference of doctors at township health center ( THC) and provide references for formulating effective policy. Methods:238 cases of doctors were sampled from Shandong, Anhui and Shaanxi provinces. Using a discrete choice experiment, we analyzed the data with a conditional logit model. Results:The most important job attribution was salary, followed by education for children, permanent post, work location, training opportunity, and years before promotion. The OR value of the monthly income of 8 000 yuan is 7. 0 compared to 2 000 yuan. Doctors will pay 3 857 yuan and 3 294 yuan respectively for better education for children and perma-nent posts. Monthly income increasing to 8 000 yuan will reduce the quitting rate from 35% to 8%, and providing better education for children and permanent posts will reduce 5%. The permanent posts at township health center and non-permanent posts in county hospital have the same appeal to the doctor. Conclusion:When choosing a job, doc-tors at THCs valued salary the most. Improving the education level for children can be beneficial for attracting and re-taining doctors at THCs. A permanent post is more attractive to doctors than non-permanent posts at THCs.

Absrtact: Osteoarthritis (OA) is a most common form of degenerative joint disease, primarily characterized by the degradation of articular cartilage, subchondral sclerosis and inflammation of the synovial membrane. Mesenchymal stem cells (MSCs), a multipotent adult stem cell population, can be isolated from many connective tissue lineages, including those of the diarthrodial joint. Joint-resident MSCs or MSC-like progenitor cells contribute to the maintenance of healthy microenvironment or to the response to trauma. The onset of degenerative changes in the joint related to abnormal condition or depletion of these endogenous MSCs and native host hyaline cartilage cells, leading to limited self-repair potential of the joint and advance of the degradation. To date, no acknowledged medical treatment strategies, including non-operative and classical surgical techniques, are efficient in restoring normal anatomy and function of hyaline cartilage in OA. This highlights an urgent need for better celled-based therapeutic strategies that supplement these functional cells exogenously to recover the tissue homeostasis and repair in joint cavity via chondrogenic and anti- in fl ammatory functions. In this review we focus on the role of native MSCs in healthy or OA joint and recent progress in cell-based researches utilizing culture-expanded chondrocytes, pluripotent stem cells, or MSCs from different sources for treating OA.

Objective To investigate whether an innovative intake duct driven from nasobiliary tube via nose improved the success rate of oronasal conversion and shorten the operation time.Methods 118 patients with routine nose bile duct drainage under ERCP examination were randomly divided into magnetic group and thread group. Patients in magnetic group were using a self-made nasal biliary drainage tube derived via nasal catheter traction and nasal catheter, one end of the magnet will be equipped with high performance through mouth to mouth pharynx, smooth delivery nose bile duct. While patients in thread group adopts godet from pharynx posterior wall drawing pulled stomach tube or catheter again, then ifx the nose bile duct.Results The success rate was signiifcantly higher in magnetic group than thread group, with less stimulation of pharynx, and less complications.Conclusion Self-made intake duct derived magnetic catheter was simple and less stimulation, avoid oral mucosa damage, reduced the suffering of patients, shortened operation time and improved the operation efifciency with high success rate.

Objective To analyze the prognostic factors associated with three-year survival outcome in patients with serous ovarian adenocarcinoma by classification tree.Methods Retrospectively we analyzed 81 cases with serous ovarian adenocarcinoma who had 3-year clinical outcomes and were hospitalized in People's Hospital from Jan 1991 to Dec 2003 by classification and regression trees(CART)software.Establish the classification tree.Results Among the factors that were associated with the 3-year survival rate,age was the most important factor,other factors in turn were International Federation of Gynecology and Obstetrics(FIGO)stage,lymphoid metastasis,residual size after operation,chemotherapy and pathologic grade.By substitution variable analysis,it was demonstrated that there was cross interaction between age and residual size as well as age and chemotherapy.Conclusion Age,FIGO stage,lymphoid metastasis,residual size after operation,chemotherapy and pathologic grade are important prognostic factors related with three-year survival probability of serous ovarian adenocarcinoma patients.

Objective To explore the changes of neutrophil elastase (NE) and surfactant protein A (SP-A) in acute lung injury(ALI) rats,and the effect of antioxidant. Methods Sixty healthy mature Wister rats were divided into 2 groups, the control group and treatment group. The rats in two groups all received peritoneal injection of E. coli to establish the ALI animal model. 30 minutes after injection of E. coli,the rats in treatment group were injected reduced glutathione from vena caudalis. The levels of NE in blood and expressions of SP-A in lung tissue were detected at 3,6 and 12 hours after injection of E. coli. Results ALI symptom appeared 3 hours after injection of E. coli in the control group, obvious after 6 hours, the rats vomi-ted pink secretion after 12 hours. Lung edema and bleeding were found by pathologic examination. No obvious symptom was found in treatment group after 3 hours, slight tachypnea after 6 hours, slight edema in pulmonary tissue after 12 hours. After administration of reduced glutathione,levels of NE at 3,6 and 12 hours in the treatment group were lower than those in the control group,and indicated statistical significance in 6 and 12 hours(P <0. 05) ;Levels of SP-A in 3,6 and 12 hours in the treatment group were higher than those in the control group, and indicated statistical significance in 3,6 and 12 hours (P < 0. 05). Conclusion Dysfunction of pulmonary surfactant is secondary in ALI, degradation of SP-A is the one of reasons, the application of reduced glutathione as antioxidant, could effectively suppress NE to decompose basosexine elastin of cells and destroy surface active protein, has protective effect on ALI.

Objective To explore the specific ultrasonic manifestation features of intracranial foreign bodies after firearm injury,and to evaluate the value of ultrasonography in detecting intracranial foreign bodies.Methods ① The specific ultrasonic manifestation features of intracranial foreign bodies were summarized by making ultrasonic scanning over known foreign bodies of different types inserted before hand in around the injury tracts.②With the summary,ultrasonic scanning was made to the foreign bodies with unknown size and types,the result was confirmed with the fetched-out foreign bodies,and the coincidence of ultrasonography in scanning the intracranial foreign bodies after firearm injury was evaluated.Results Ultrasonography could distinguish intracranial foreign bodies from brain parenchyma,intraeranial foreign bodies of different types had different ultrasonic manifestation features.The size and the materials of the foreign bodies had certain affection on the result of ultrasonic scanning.The accuracy of qualitative judgement in scanning the intracranial foreign bodies was 71.52％,and the accuracy in scanning the foreign bodies with diameter ＞ 0.5 cm was higher than that with the diameter ＜ 0.5 cm.The coincidence in qualitative judgement of the foreign bodies of different materials ranged as follows:bullet (97 ％ )＞ steel ball (81.13％),bone pieces (78％) and glasses (72％) ＞gauze (54.67％) and wood pieces (54.67％).Conclusions The intracranial foreign bodies of different materials have specific ultrasonic manifestation features and ultrasonography can scan out their locations.The coincidence of qualitative judgement in scanning the bodies with diameter over 0.5 cm is high.Ultrasonography may be of important significance in guiding the fetch-out of intracranial foreign bodies on the spot and in raising the rescuing level of firearm injury.

OBJECTIVETo investigate the effects of Wuhuang Tangkangling on tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) in serum of patients with type 2 diabetes mellitus (T2DM).

METHODOne hundred cases of type 2 diabetes mellitus patients were randomly divided into two groups. The control group was treated with pioglitazone (15 mg x d(-1)) orally once a day in the morning, combined with insulin subcutaneous injection based on blood glucose level. The treatment group was treated with decoction of Wuhuang Tangkang Ling daily, 8 weeks as a course. TNF-alpha, IL-6, hs-CRP, fasting blood glucose (FBG) and postprandial blood glucose (PBG) were tested for two groups of patients before and after the treatment And other 50 healthy cases were tested for comparison.

RESULTBefore treatment, the level of cytokine, FBG and PBG in the serum of patients with T2DM were significantly higher than healthy cases (P < 0.01). In treatment group, difference between before and after the treatment had statistical significance (P < 0.01); after treatment, difference between treatment group and control group had statistical significance (P < 0.01).

CONCLUSIONWuhuang Tangkangling could significantly decrease the level of TNF-alpha, IL-6, hs-CRP, FBG and PBG in patients with T2DM, and could decrease blood glucose, anti inflammatory, and improve insulin resistance. According to testing these cytokines, a new criteria for evaluating the progress of T2DM and the treatment may be approached.

C-Reactive Protein ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Interleukin-6 ; blood ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo investigate the clinical effect of decoction of invigorating Qi and clearing lung combined standardized myrtol on acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

METHODNinety and eight patients with AECOPD patients were randomly divided into the treatment group and the control group, with 50 cases and 48 cases respectively. All the patients were given the conventional treatment. The control group was treated by standardized myrtol with 3 times a day, 300 mg each time taken orally. The treatment group was given decoction of invigorating Qi and clearing lung with 2 times a day, one dose per day taken orally, combined standardized myrtol (usage as above). After Two weeks, the scores of clinical symptom, blood gas analysis and pulmonary function were observed.

RESULTBoth FEV1 and FEV1% were raised in the two groups after treating. And the treatment group was significantly higher than control group (P < 0.01). PaO2 and PaO2/FiO2 rose, with PaCO2 decreased in the two groups (P < 0.01). PaO2 and PaO2/FiO2 were significantly improved, and PaCO2 was significantly decreased in the treatment group compared to the control group (P < 0.01). In the clinical curative effect comparison aspects, clinical control rates were 42.0% in treatment group and 20.83% in control group respectively, with significant difference between the two groups (P < 0.05). Significant efficiency is 86.0% in treatment group and 52.08% in control group respectively, with significant difference between the two groups (P < 0.01).

CONCLUSIONDecoction of invigorating Qi and clearing lung combined with standardized myrtol can obviously improve clinical symptom, blood gas an analysis and pulmonary function in patients with AECOPD.

Aged ; Blood Gas Analysis ; Drug Combinations ; Drug Therapy, Combination ; Female ; Humans ; Lung ; physiopathology ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Monoterpenes ; standards ; therapeutic use ; Pulmonary Disease, Chronic Obstructive ; blood ; physiopathology ; therapy ; Reference Standards ; Respiratory Function Tests ; Treatment Outcome