OBJECTIVETo observe the clinical effectiveness of Sanmiao Powder (SP) combined fibrinogenase for injection in treatment of acute deep venous thrombosis (ADVT) of lower limbs.

METHODSEighty patients with ADVT were randomly assigned to two groups according to the disease course (within 7 days or 7-28 days), 40 in each group. Every time phase was also divided into two groups, i. e., one group treated with fibrinogenase for injection alone (Group A and C) and another group treated with fibrinogenase for injection + SP administration (Group B and D) , 20 in each group. The clinical effectiveness was observed after 2-week treatment.

RESULTSThe fibrinogenase for injection + SP administration showed better effects in alleviating the swelling of limbs, relieving pain, and lowering fibrinogen. Better effects were obtained in the group with the disease course less than 7 days.

CONCLUSIONBetter effect on ADVT was obtained by integrative medicine.

Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lower Extremity ; blood supply ; Male ; Metalloendopeptidases ; therapeutic use ; Middle Aged ; Phytotherapy ; Venous Thrombosis ; drug therapy

Objective To study the MR performances of finger joints with health subjects and rheumatoid arthritis (RA)patients,and to detect the imaging quality of a custom-made finger coil.Methods Finger coil,extremity coil,flexible surface coil and 3 inch surface coil were used to scan the self-made water phantom with similar T2 WI sequence,then the signal to noise ratio (SNR)on single image was measured for the comparison.The middle finger specimen (1 finger)was used for the research,5 healthy volunteers (8 fingers)and 18 RA patients (22 fingers)were also scanned.Results The SNR of finger coil was over 1.5 times higher than that of the 3 inch surface coil and 4 times higher than that of the extremity coil and flexible surface coil.For the 22 fingers with confirmed RA,synovitis was found in 1 7,joint effusion in 10,bone marrow edema in 5,bone erosion in 7 and tenosynovitis in 6.Conclusion The finger coil has higher SNR.

Confronted with similar problems and difficulties in mainland,Taiwan reformed its medical education. The reform included setting up flexible program,formulating objective and detailed rotary guide,making the best of the resources,implementing medical humanities education based on the reality and forming unique cultivation system and mode. These measures can be taken as references for medical education reform in mainland.

By analysing the anatomy of upper cervical segment, the atlas - axis relation in plain X - ray film in 3-1 cases revealed that the joint displacement is one of the important causes for vertebral artery type or sympathetic type cervical spondylopathy. The main manifestations for diagnosing atlas - axis displacement included headache, dizziness, unilateral protrusion and tenderness of the affected vertebra, displacement of tooth protrusion up to 1 mm at anterior mouth -open positions. The most effective therapy was accurate and dexterousmanipulation for reduction.

OBJECTIVETo evaluate the midterm follow-up results of extended release of posterior clearance in total knee arthroplasty.

METHODSA total of 120 patients with knee osteoarthritis were equally randomly assigned to the experimental group and control group, and underwent unilateral TKA from March 2010 to March 2012. In experimental group, there were 21 males and 39 females with an average age of (62.2±10.9) years old. In the control group, there were 25 males and 35 females with an average age of (64.9±11.4) years old. All the patients were performed using the anterior knee approach. During operation, after osteotomy of the tibia and the femoral condyle, extended release of the posterior knee clearance were taken in experimental group, while only the clearance of osteophyte in the posterior condyle were performed in the control group. The KSS scores including knee functional score and knee clinical score,as well as the range of motion (ROM) of patients, were compared between the two groups at midterm follow-up.

RESULTSTotally 49 patients in the experimental group and 54 patients in the control group were followed up, and the median follow-up time was 46 months. The knee functional score of patients in the experimental group was 91.3±3.4, which was better than 86.4±3.9 of patients in the control group; initiative ROM of flexion of patients in the experimental group was (133.2±5.9)°, which was better than (126.9±7.4)° of patients in the control group. There were no significant difference of knee clinical score between 86.9±4.6 of patients in the experimental group and 85.7±5.1 of patients in the control group, and the initiative ROM of extension between (0.5±1.1)° and (0.3±1.2)°.

CONCLUSIONExtended release of the posterior knee clearance contributes to the knee function and initiative flexion ROM during a midterm follow-up and patients benefit.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Case-Control Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular

Comparing with the Western medicine, the clinical pathway development of Chinese medicine (CM)/integrative medicine (IM), on one hand, should follow the basic principles of general clinical pathway; on the other and prior hand, it ought to coordinate with the rule of CM, and display sufficiently the advantages of CM based upon the evidences. Several key issues which may be encountered in the development and the relevant strategies were introduced in this paper.
Critical Pathways ; Integrative Medicine ; methods ; Medicine, Chinese Traditional ; methods

The NF-kappaB pathway regulates the expression of over 150 target genes, e.g., cytokines, chemokines, leukocyte adhesion molecules and inducible effector enzymes. Consequently, it plays a crucial role in innate and adaptive immune responses, inflammatory response, stress responses, apoptosis and so on. IkappaB kinase (IKK) is the key of this pathway, and it owns a special structure which consists of catalytic subunit and regulatory subunit. Naturally, the activation of IKK needs the interaction of the two subunits and phosphorylation by its upstream kinases. Actually, there are two methods of activation of the NF-kappaB pathway, and both of the methods need the IKK complex. Given to the crucial role of IKK, researchers have isolated and synthesized amounts of IKK inhibitors, and these provide a great convenience to develop novel anti-inflammatory and anti-tumor drugs.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Antineoplastic Agents ; pharmacology ; Enzyme Activation ; Enzyme Inhibitors ; metabolism ; pharmacology ; Humans ; I-kappa B Kinase ; antagonists & inhibitors ; chemistry ; metabolism ; physiology ; NF-kappa B ; metabolism ; Phosphorylation ; Signal Transduction

Objective To clarify the clinical features,therapeutic strategy and prognosis of lipid storage myopathy (LSM).Methods The clinical data and therapeutic effects of 42 LSM patients were summarized retrospectively.All patients were followed up to evaluate their prognosis.Results Data of short-term therapeutic results of all the 42 patients were available.Thirty-three cases were placed in low- doses prednisone and 9 cases in riboflavin.All patients showed marked and quick improvement of symptoms within one month.Among thirty-two patients followed up for more than one year,26 cases had a full recovery and 6 remained to have intolerance to heavy exercise.Thirteen patients had relapses of muscle weakness in various degrees and most of which were induced by exertion,exposure to coldness and upper respiratory tract infection.In 5 patients the symptoms were recurred for more than one time.Among 13 cases with relapses, 7 had family history.Conclusions Our data suggest that LSM is a treatable disease and well responsive to low-doses prednisone.The disease tends to recur,especially in patients with family history.Glutaric aciduria type Ⅱ should be considered in LSM patients who are responsive well to riboflavin,indicating drug therapeutic strategy for LSM should be based on the etiology of the disease.

Objective To evaluate the ergotropic effect of bone cement on pedicle screw fixation in treatment of osteopo-rotic thoracolumbar fracture.Methods Fifty-three patients with osteoporotic thoracolumbar fracture, admitted from Jun. 2013 to Dec. 2014, were included for treatment by augmentation of pedicle screw fixation with bone cement. All patients underwent pre-operative examination of bone mineral density with T-score ≤-2.5 and augmentation of pedicle screw fixation with injection of 1.5 ml bone cement in adjacent to fractured vertebra. All patients were treated with anti-osteoporosis therapy pre- and post-operation, ob-served and recorded with basic conditions and complications. At pre-operation, one-week post-operation and last follow-up, pain vi-sual analogue scale (VAS) and neurological function score (ASIA) of all patients were recorded, and the compression rats of anterior and posterior edge of fractured vertebra, and compression rats of spinal canal and Cobb angel of all patients were measured.Results All the 53 patients were successfully undergone operation in about 90-140 min with blood loss of about 150-350 ml. No spinal cord or nerve injury, dural tear and obvious leakage of bone cement and screw loosening occurred during operation. All patients were followed up for 12 to 36 months and the neurological function obviously recovered contrasted with pre-operation. X-ray and CT examination at last follow-up showed good fractures healing, good position and non-loosening of internal fixation device and non-leakage of bone cement. At one week post-operation and last follow-up, VAS, compression rats of anterior edge and posterior edge of fractured vertebra, compression rats of spinal canal and Cobb angel were significantly lower than those at pre-operation (P<0.05), but no significant differences existed on these parameters between 1 week post-operation and last follow-up (P>0.05).Conclusions Augmentation of pedicle screw fixation with bone cement can effectively strengthen the initial stability of pedicle screw in osteo-porosis, restore the height of fractured vertebra and reduce the compression of spinal canal, which will help the correction of spinal kyphosis and neurological function recovery. This method can well maintain long-term stability of internal fixation in osteoporosis and height of fractured vertebra, and significantly reduce the risks of long-term screw loosening and vertebral collapse.

OBJECTIVETo summarize experiences of serious perioperative complications management of obstructive sleep apnea hypopnea syndrome (OSAHS), and evaluate the effect of intervention in decreasing the incidence of serious complications.

METHODSRetrospective analysis of clinical data in Shenyang General Hospital of PLA and Liaoning Province Jinqiu Hospital of OSAHS surgery cases from January 1995 to December 2009 were included in this study, patients were divided into two groups according to with or without intervention. Experience and lessons were analyzed.

RESULTSPatients without and with intervention were 402 and 521 respectively, and uvulopalatopharyngoplasty (UPPP) cases in each group were 387 and 390. Five patients in the first group who accepted UPPP had breathing difficulty and were all successfully rescued, while no one in the second group had breathing difficulty. The difference was significant (P < 0.05). Sixteen patients in the first group had severe bleeding after UPPP, while only 5 patients had the severe bleeding in the second group. The difference was significant, too P < 0.05. No breathing difficulty cases in the second group, and serious bleeding cases in each group was 5 and in 1, there was no significant difference (P > 0.05).

CONCLUSIONSBreath difficulty and serious bleeding are serious perioperative complications of OSAHS surgery, and with systemic intervention the incidence of the complications can be decreased.

Adolescent ; Adult ; Aged ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Palate, Soft ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery ; Young Adult