[Objective]To compare the treatment effects between posterior single segment fusion or non-fusion in lumbar spinal disease,and to evaluate their influence on adjacent segments.[Method]Thirty-two cases of degenerative lumbar spinal disorders were treated with Coflex(group non-fusion) and PLIF(group fusion),and followed up for over 2 years.The clinical effect was evaluated by visual analogue scale(VAS) and Oswestry disability index(ODI).Range of motion(ROM) of lumbar segments was measured by X-ray film.[Result]In group non-fusion,VAS decreased from 7.8?1.2 pre-operatively to 2.1?0.6 at final follow-up,ODI from 30.8?3.2 to 4.6?1.2,ROM improved significantly.In group fusion,VAS decreased from 7.2?1.1 to 2.0?0.6,ODI from 29.9?3.0 to 4.5?0.9,and ROM of L3、4 improved significantly.No significant difference of clinical effect was found between 2 groups.[Conclusion]Both fusion and non-fusion fixation have satisfying effects in treatment of degenerative lumbar spinal disorder.Non-fusion fixation has less influence on ROM of lumbar segments and could reduce adjacent segment degeneration.

OBJECTIVETo investigate the effectiveness of polycystic ovary syndrome (PCOS) of damp-phlegm constitution treated with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10).

METHODSEighty-five patients were randomly divided into 2 groups of observation group (42 cases) and control group (43 cases). Embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10) were applied to the observation group. Points such as Zhongwan (CV 12), Guanyuan (CV 4), Tianshu (ST 25), Zhangmen (LR 13), Jingmen (GB 25), Qimen (LR 14), Ganshu (BL 18), Weishu (BL 21), Pishu (BL 20), Shenshu (BL 23), Dachangshu (BL 25) and Xiaochangshu (BL 27), etc. were adopted for embedding therapy. At the same time, needle-pricking therapy on Sifeng (EX-UE 10) was also applied once a week. 0. 5 g metformin hydrochloride tablet was given to the control group, once a day for the first week, and twice a day from the second week. Estimation on therapeutic effect was made for both groups after 3 months treatment. Change of symptoms and signs scores, fasting insulin (FINS), 2 hour insulin after meal (2hINS) and insulin resistance index (HOMA-IR) of both groups before and after treatment were observed, and therapeutic effect estimated.

RESULTSThe total effective rate of the observation group is 97. 6% (41/42), and that of the control group was 95. 4% (41/43). There was no significant difference between the two groups (P>0. 05). Scores of symptoms and signs after treatment were significantly improved in both groups (all P<0. 01), and the observation group was better than the control group (7.01+/-4.23 vs 8. 47+/-2. 82,P<0. 05). Compare with those before the treatment, FINS, 2hINS and HOMA-IR after the treatment were all decreased in both groups (all P<0. 05). The comparison between the two groups showed that differences of FIN had no statistic significance (P>0. 05) after the treatment, while both differences of 2hINS and HOMA-IR had statistic significance [ 2hlNS: (443. 531+/- 93. 90) pmol/L vs (621.29+/-93. 87) pmol/L ; HOMA-IR: 4. 88+/-0. 30 vs 5.06+/-0. 32, both P<0. 05]. The improvement of 2hINS and HOMA-IR in the observation group was better than that of the control group.

CONCLUSIONTreatment of PCOS of damp-phlegm constitution with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10) have positive effect, which can effectively reduce the insulin resistance, meanwhile, reduce the side-effects of western medication.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Polycystic Ovary Syndrome ; therapy ; Treatment Outcome ; Young Adult

Objective To observe the effect of application in canicular days on the quality of life and immune substances in patients with allergic rhinitis (AR), and its therapeutic efficacy for AR. Method Sixty-four AR patients were divided into a treatment group of 34 cases and a control group of 30 cases by using the random number table. The treatment group was intervened by acupoint application in canicular days, while the control group was by placebo adhered to the same points. The Short-Form (36) Health Survey (SF-36) and Self-rating Rhinitis Scale (RS) were evaluated before and after the intervention; the serum total immunoglobulin E (T-IgE) and eosinophil cationic protein (ECP) were detected before and after each treatment session, and the changes of the parameters were compared. Result The global scores of SF-36 and RS, and the level of serum ECP were significantly changed after intervention (P<0.05); there was no significant change in serum T-IgE after treatment (P>0.05). Conclusion Application in canicular days can promote the quality of life, improve rhinitis symptoms, and down-regulate the level of serum ECP, indicating that application in canicular days can produce a satisfactory efficacy in treating allergic rhinitis.

OBJECTIVETo explore the clinical effects of negative pressure wound therapy (NPWT) combined with artificial dermis grafting and autologous skin grafting on repair of open joint wounds and/or wounds with exposed bone fracture.

METHODSEleven patients with open joint wounds and/or wounds with exposed bone fracture, hospitalized from November 2008 to November 2014, were enrolled in the study. According to the differences of the first stage treatment, all patients were divided into experimental group ( n = 6, including 4 patients of open joint wounds, 1 patient of wound with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture), and control group ( n 5, including 2 patients of open joint wounds, 2 patients of wounds with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture). After debridement, the wounds in both groups were grafted with punctured artificial dermis, while NPWT was only used over the artificial dermis of experiment group for 1 week. In the operation at sacsod stage, autologous split-thickness skin was grafted on the vascularized artificial dermis in both groups. Results In 5 patients of open joint wounds in experimental group, the artificial dermis was vascularized well, autologous skin grafts survived, and wounds were healed. In 3 patients of open joint wounds in control group, the artificial dermis grafting all failed due to local infection, and then these wounds were repaired with local tissue flap grafting. Artificial dermis in 3 patients of wounds with exposed bone fracture in both groups was vascularized well after grafting, and the wounds were healed after autologous skin grafting, whether or not NPWT was used.

CONCLUSIONSNPWT combined with artificial dermis grafting and autolognus skin grafting can be used for repairing open joint wounds and/or wounds with exposed bone fracture.

Debridement ; Dermis ; transplantation ; Humans ; Negative-Pressure Wound Therapy ; methods ; Skin Transplantation ; methods ; Skin, Artificial ; Surgical Flaps ; Wound Healing

Objective: To learn anxiety, depression, sleep quality and quality of life among patients with primary pruritus ani, and to analyze their correlation with anal itching symptom, so as to provide insights into the prevention and treatment of primary pruritus ani. Methods: Patients with primary pruritus ani were selected from anorectal department of the First Affiliated Hospital of Zhejiang Chinese Medical University. The Visual Analogue Scale, pruritus frequency score, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index and Dermatology Life Quality Index (Chinese version) were used in the survey. Spearman rank correlation analysis was employed to analyze the correlation between the degree and frequency of pruritus ani with, anxiety, depression, sleep quality and quality of life. Results: Sixty patients with primary pruritus ani were investigated, including of 7 males and 53 females, with an average age of (34.37±10.30) years. The patients with mild, moderate and severe pruritus accounted for 28.33%, 48.33% and 23.34%, respectively. The patients with pruritus frequency of grade 1, 2 and 3 accounted for 51.67%, 38.33% and 10.00%, respectively. The patients with anxiety, depression, and coexistence of anxiety and depression accounted for 18.33%, 13.33% and 10.00%, respectively. The patients with very good, good, average and poor sleep quality accounted for 15.00%, 46.66%, 30.00% and 8.34%, respectively. No, mild, moderate and severe impacts on quality of life among the patients accounted for 10.00%, 46.66%, 33.34% and 10.00%, respectively. The degree of pruritus was positively correlated with anxiety (rs=0.405, P=0.001), depression (rs=0.343, P=0.007), sleep quality (rs=0.293, P=0.037) and quality of life (rs=0.338, P=0.008). However, there was no significant correlation between the frequency of pruritus with the above factors (all P>0.05). Conclusion The degree of pruritus in patients with primary pruritus ani is related to anxiety, depression, sleep quality and quality of life.

OBJECTIVETo compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius.

METHODSFrom January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up.

RESULTSTwo cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,P<0.05); after 12 months' following up, advanced Gartland-Werley score was respectively 2.66 +/- 1.01 and 3.08 +/- 1.00, but with no statistical meaning (t=-1.55, P>0.05).

CONCLUSIONLCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.

Adult ; Aged ; Bone Plates ; External Fixators ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius ; surgery ; Radius Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the effect and mechanism of curcumin derivative B06 on kidney from rats with hyperlipidemia and type 2 diabetes.

METHODSThirty five male SD rats were randomly divided into five groups(n = 7): the normal control group, high-fat group, high-fat + B06-treatd group, diabetic group, diabetic + B06-treated group. After fed with high-fat diet for 4 weeks, the later two groups were in- jected with streptozotocin intraperitoneally to induce type 2 diabetes mellitus. B06-treated groups were given B06 by gavage at a dosage of 0.2 mg/kg . d for 8 weeks. After the treatment, the serum creatinine, blood urea nitrogen and uric acid were detected biochemically, the morphology of kidney was observed with light and transmission electron microscopy, the expression of collagen fibers was observed with Masson staining, the protein expression of collogen IV and fibronectin in kidney were determined by Immunohistochemistry.

RESULTSIt was showed that the levels of the serum creatinine and blood urea nitrogen elevated significantly in diabetic group. In high-fat and diabetic groups, increased glomerular mesangial matrix and collagen fiber and thicken glomerular basal membrane were observed under light microscopy, swelling and fusion of foot process were found under electron microscope; increased green matrix within glomeruli was observed under Masson staining. collogen IV and fibronectin protein expression were significantly enhanced in high-fat group and diabetic group. After B06's intervention, the levels of serum creatinine and blood urea nitrogen were decreased in diabetic groups, the morphological change of kidney was obviously relieved, Collogen IV and fibronectin protein expression reduced.

CONCLUSIONCurcumin derivative B06 exerts a protective effect on kidney in type 2 diabetic rats, reduced expressions of collogen IV and fibronectin, inhibition of the accumulation of extracellular matrix and glomerular mesangial proliferation, and then prevention of renal fibrosis may be the mechanism.

Animals ; Blood Urea Nitrogen ; Collagen Type IV ; metabolism ; Creatinine ; blood ; Curcumin ; pharmacology ; Diabetes Mellitus, Experimental ; complications ; drug therapy ; Diabetes Mellitus, Type 2 ; Drugs, Chinese Herbal ; Fibronectins ; metabolism ; Kidney ; metabolism ; physiopathology ; Kidney Diseases ; drug therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Uric Acid ; blood

Objective To explore the relationship between B-type natriuretic peptide (BNP) and fibrinogen (Fib) in the elderly patients with coronary heart disease (CHD). Methods According to the level of BNP,325 subjects aged more than 65 years were divided into four groups,BNP:≤32.4ng/Lgroup,32.5～62.3 ng/Lgroup,62.4～162.5 ng/Lgroup,＞162.5 ng/L group.The levels of left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD) and Fib were compared among the groups. Results With increasing BNP level,the LVEF was gradually decreased [(63.3±8.2)％,(59.6±7.4)％,(57.9±9.7)％,(55.2±10.6)％] and the level of LVEDD was increased[(50.5±4.7)mm,(51.4±5.4)mm,(52.8±5.7)mm,(54.2±5.9)mm ;F=11.54,6.76,both P＜0.01],the level of Fib was enhanced [(3.4±0.7)g/L,(3.7±0.8)g/L,(3.8±1.1)g/L,(4.2±1.0)g/L; F=8.02,P＜0.01].The level of BNP had positive correlation with Fib (r=0.25,P＜0.01). Multi-linear regression analysis showed that Fib and LVEF were influencing factors of BNP (t =2.92, - 3.15, both P ＜ 0.01 ). Conclusions The BNP level is helpful to diagnose heart failure and assess heart function.There is an association between BNP and Fib level.

Objective To explore the relationship between blood lipids and creatinine clearance (Ccr)in aged patients with coronary heart disease(CHD).Methods According to coronary artery angiography(CAG)and Ccr,784 subjects aged 65 years and over were divided into groups and Their lipid levels were compared.Results With increasing lesion of coronary branches,the level of Ccr was obviously decreased(F=5.35,P＜0.01).The level of apolipoprotein A1(ApoA1)was reduced and apolipoprotein B(ApoB)enhanced in renal function of moderate-severe injury(CCr＜0.83 ml ·s-1 · 1.73m-2)(F=5.31,F=4.91,both P＜0.01).The level of ApoA1 was decreased(F=3.52,P＜0.05)and Apo B increased(F=5.65,P＜0.01)in male renal function of moderate-severe injury.The levels of ApoA1 decreased(F=5.79,P＜0.01),ApoB increased(F=4.56,P＜0.05)and high density lipoprotein-cholesterol reduced(F=3.39,P＜0.05)in CHD with renal group of moderatesevere injury.Multi-logistic regression analysis showed that Ccr,HDL-C,ApoA1 and ApoB were influencing factors of CHD.Conclusions Abnormal blood lipid and renal dysfunction are risk factors of CHD,dyslipidemia may induce renal dysfunction.It is important to control lipids and improve other organ functions in the aged patients with CHD.

Objective To study the receptors signaling of prostaglandin E2 on the differentiation of regulatory T (Treg) cells and Th17 cells.Methods The expression of prostaglandin E2 receptors (EP1/EP2/EP3/EP4) on the MACS-purified CD4+CD62L+ T (Th0) cells was analyzed by flow cytometry and reverse transcription polymerase chain reaction (RT-PCR).The quantity of CD25+Foxp3+ cells was examined by flow cytometry,the expression of FoxP3 mRNA and RORγt mRNA were detected using real-time RT-PCR,the level of IL-17 in the culture supernatants was detected by enzyme-linked immunosorbent assay (ELISA).ANOVA,LSD-t,Dunnett T3 were used for statistical analysis.Results EP1,EP2,EP3,EP4 were expressed on Th0 cells at different levels,and EP2 [(89.7±9.1)％] had the strongest expression.PGE2 [(3.0± 2.2) ％],EP2 agonist [(4.5± 1.0) ％] and EP4 agonist [(8.8 ±2.5) ％] decreased the quantity of CD25 +Foxp3 + cells compared with the control group [(28.6±6.8)％] (t=7.156,P=0.021; t=6.958,P=0.032; t=5.359,P=0.044).PGE2(0.210±0.020),EP1 agonist (0.833±0.045),EP2 agonist (0.227±0.025) and EP4 agonist (0.450±0.060) decreased the expression of Foxp3 mRNA compared with the control group (1.000) (t=23.817,t=5.026,t=23.313,t=16.581; all P=0.000).PGE2 [(22±6)pg/ml],EP2 agonist [(24±5)pg/ml]and EP4 agonist [(207±19) pg/ml] decreased the secretion of IL-17 compared with the control group [(678±87) pg/ml] (t=14.925,P=0.004; t=14.873,P=0.004; t=10.480,P=0.008).PGE2 (0.141±0.027),EP1 agonist (0.869±0.033),EP2 agonist (0.176±0.029) and EP4 agonist(0.371±0.042) decreased the expression of RORγt mRNA compared with the control group (1.000) (t=34.046,t=5.184,t=32.673,t=24.962,all P=0.000).Conclusion EP1,EP2,EP3,EP4 receptors are expressed on CD4+CD62L+ T (Th0) cells at different levels.Prostaglandin E2 inhibits the differentiation of Treg cells and Th17 cells via the EP2 and EP4 receptors signaling.