Objective To investigate the serum C-reactive protein (CRP) level in patients with acute cerebral infarction and acute massive cerebral infarction with multiple organ dysfunction syndrome (MODS),and analyze the clinical value of CRP. Methods The serum CRP level of 50 patients of control group and 50 patients of cerebral infarction admitted to hospital within 7 days (30 patients were admitted into acute cerebral infarction group and 20 patients into acute massive cerebral infarction with MODS group) were determined by immune scatter turbidimetry. Results (1)In cerebral infarction patients,serum CRP level in 48 cases(96%) was equal and over 5 mg/L.In control group,serum CRP level in 3 cases(6%) was equal and over 5 mg/L(P＜0.0 5).(2)The level of serum CRP acute in cerebral infarction group and in acute massive cerebral infarction with MODS group increased significantly than that in control group (P＜0.01).The level of serum CRP in acute massive cerebral infarction with MODS group increased significantly than that in acute cerebral infarction group.(3)When the level of CRP＜25 mg/L,the incidence of MODS in patients with acute cerebral infarction was zero.When the level of CRP≥25 mg/L,the incidence of MODS increased gradually with the rise of CRP. Conclusions There is positive correlation between the serum level of CRP and the severity of acute cerebral infarction and the incidence of MODS.CRP is a useful marker in predicting the prognosis of acute massive cerebral infarction with MODS.

Objective To evaluate diagnostic value of X-ray computed tomography(CT) neck masses in children.Methods Clinic,pathologic diagnosis and CT scans of 26 patients from Jan.2004 to Jun.2006 with neck masses which location,density,edge and near construction were reviewed retrospectively.Results Seven cases in neck anterior area,13 cases in neck lateral area,6 cases in other areas or unconfirmed.Eight cases with lower density than cervical muscles,2 cases with same density,2 cases with higher density,14 cases with mixed density.Inflammatory masses were observed in 13 cases,congenital malformation in 11 cases,thyroiditis in 1 case,pharyngeal tumor-like proliferation in 1 case.Conclusion CT scan is the best choice of diagnosis of neck masses in children,and is valuable to diagnosis associated with history and physical examination.

Objective In patients with pulmonary atresia and intact ventricular septum ( PAIVS) without right ventricular-dependent coronaries, catheter techniques including the use of a sniff wire, lasers, and radiofrequency have been the most widely used initial therapy. However, percutaneous perforation and balloon valvuloplasty were associated with higher rate of procedural failure and serious complications. Methods We report our experience with a hybrid approach for pulmonary atresia with intact ventricular septum, combining surgery and interventional catheterization techniques. Between March 2005 and March 2010, hybrid procedure was carried out successfully in 30 newboms and infants with favorable anatomy. The age ranged from 1 day to 48 months with a mean of (4.59 ±3.21) months. The heart was exposed through median sternotomy. A pursestring suture was placed in the right ventricular outflow tract 2 cm away from the pulmonary trunk. Then a 16-gauge intravenous catheter was punctured through the right ventrical and perforated the atretic PV with the guidance of echocardiography. A guide wire was then inserted into the sheath and used to guide the balloon across the PV. Sequential dilations were performed until a full opening of the PV with the guidance of epicardial echocardiography. In patients ＜ 3 months PDA ligation was performed followed by modified Blalock-Taussig (B-T) shunt. In patients ＞ 3 months PDA ligation was not performed. A modified B-T shunt was inserted if severe systemic oxygen desaturation occurred after PDA ligation. Bidirectional Glenn shunt was performed for severe hypoplasia. Hybrid procedure was achieved in all patients. The simultaneous procedures included 25 cases of PDA ligation. 6 newborns underwent modified B-T shunt placement (3.5 to 5 mm) after pulmonary valvuloplasty and PDA ligation, and 2 patients ＞ 1 month underwent modified B-T shunt. Another 2 patients were selected for univentricular palliative surgery because of a diminutive monopartite right ventricle and bidirectional Glenn procedure was performed. No pericardial effusion or cardiac tamponade was observed in all patients. Another case without PDA ligation underwent a modified B-T shunt because of hypoxemia three days after hybrid procedure, and the rest patients were discharged without any further surgical intervention.During the follow-up period of 1.5 to 62.0 months, 5 patients died. 25 (83.3%) survived and were all in New York Heart Association functional class 1. Peripheral oxygen saturation increased from 0.73 ± 0.08 to 0.94 ± 0.04 (P ＜ 0.05). One patient remains in a single-ventricle pathway, whereas 24 patients achieved a two-ventricle circulation. Results Conclusion Perventricular balloon pulmonary valvuloplasty using a hybrid approach is a safe and feasible procedure for patients with PAIVS.

Objective To observe the difference in treament of thoracolumbar vertebral bodies fractures be- tween AF nail and Dick nail.Methods From March 1998 to March 2007,85 cases of thoracolumbar vertebral bod- ies fractures were followed up.20 cases were fixed with Dick nail,and 65 cases with AF nail.Results The mean,fol- low-up period was 12 months.By comparison of the operating rime,bleeding amount,the recovery rate of vertebral height,the reduction of Cobb angle and capacity of vertebral canal,AF nail was much better than Dick nail.But there was no marked difference in the recover of nerve function.Conclusion AF nail has more power to reduce vertebral height and is easier to set than Dick nail.It will be worthy of more and wider application in basic level hospitals.

Objective To investigate the effects of high spermatic vessel dissection on testicular morphological alteration of SD rats in prepuberty,puberty and sexual maturity phases.Methods Thirty-day-old SD rats were divided into 2 groups underwent sham operation and left high spermatic vessel dissection as a simulation of Palomo′s maneuver.Detailed morphological investigations were made at 3 different postoperative intervals among the 3rd day,30th day and 56th day.Results High spermatic vessel dissection in prepubertal rats induced acute testicular ischemia in the operated testes on the 3rd day.Most of the operated testes on the 30th day showed testicular atrophy.And all the operated testes showed testicular atrophy and sperm disappearance in epididymis on the 56th day.Conclusion High dissection of spermatic vessel in prepubertal rats induced testicular ischemia in prepuberty and testicular growth failure in puberty,testicular atrophy completely and sperm production losing in sexual maturity phase.

"Paired medicine" belongs to the TCM compatibility, and is often relatively fixed applied in some special cases, with advantages of positive efficacy and simplified medication. The efficacy of paired medicine is not derived from the use of single medicine. It's new function can be realized through the compatibility between single medicine. Professor WEI Zi-xiao is expert in using paired medicine. Most of his commonly used paired medicine comes from some famous TCM prescriptions. Professor WEI Zi-xiao brings forth new ideas on the basis of his own experience and the outcome of modern research, with obvious clinical efficacy.

BACKGROUNDAdjacent segment degeneration could seriously affect the long-term prognosis of lumbar fusion. Dynamic fixation such as the interspinous fixation, which is characterized by retaining the motion function of the spinal segment, has obtained satisfactory short-term effects in the clinical setting. But there are few reports about the biomechanical experiments on whether dynamic fixation could prevent adjacent segment degeneration.

METHODSThe surgical segments of all 23 patients were L4/5. Thirteen patients with disc herniation of L4/5 underwent Wallis implantation surgery, and 10 patients with spinal stenosis of L4/5 underwent posterior lumbar interbody fusion (PLIF). L3-S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device during surgery when the vertebral plate was exposed or during spinal decompression or internal fixation. Five fresh, frozen cadavers were used in the self control experiment, which was carried out in four steps: exposure of the vertebral plate, decompression of the spinal canal, implantation of a Wallis fixing device, and PLIF of L4/5 after removing the Wallis fixing device. Then, L3-S1 segment stiffness was measured by an SSG device.

RESULTSThe experiments showed that the average stiffness of the L4/5 segment was (37.1 ± 8.9) N/mm after exposure of the vertebral plate, while after spinal decompression, the average stiffness fell to (26.2 ± 7.1) N/mm, decreasing by 25.8% (P < 0.05). For the adjacent segments L3/4 and L5/S1, their stiffness showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate (P > 0.05). After Wallis implantation of L4/5, the stiffness of the cephalic adjacent segment L3/4 was (45.8 ± 10.7) N/mm, which was 20.5% more than that after the exposure of the vertebral plate (P < 0.05); after L4/5 PLIF surgery, the stiffness of L3/4 was (35.3 ± 10.7) N/mm and was decreased by 12.4% more than that after the exposure of the vertebral plate (P < 0.05). The stiffness of the cephalic adjacent segment L3/4 after fixation in the Wallis group was significantly higher than that of the PLIF group (P < 0.05). Cadaver experiments showed that the stiffness of the cephalic adjacent segment in the Wallis group was significantly higher than that of the PLIF group after L4/5 segment fixation (P < 0.05); the stiffness of the L5/S1 segment showed no significant difference between PLIF surgery and Wallis implantation (P > 0.05).

CONCLUSIONSAfter interspinous (Wallis) fixation, the stiffness of the cephalic adjacent segment increased. After PLIF with pedicle screw fixation, the stiffness of the cephalic adjacent segment decreased. An interspinous fixation system (Wallis) has a protective effect for cephalic adjacent segments for the immediate post-operative state.

Adult ; Bone Screws ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; instrumentation ; methods

OBJECTIVETo study the effect of matrine (MAT) on the proliferation of human ovary malignant teratoma cell line PA-1 in vitro.

METHODSPA-1 cells allocated in different groups were treated with different concentrations (0.25 mg/mL, 0.5 mg/mL and 1.0 mg/mL) of MAT. The inhibitory effect of MAT and its dose- and time-effect relationship were detected with MTT; the apoptosis rate and cell cycle were evaluated by flow cytometry; and the changes of bcl-2/bax mRNA expression in cells were measured using semi-quantitative RT-PCR.

RESULTSAfter being exposed to MAT, the PA-1 cell proliferation was decreased in a concentration- and time-dependent manner; cell apoptosis rate raised as the increasing concentration of MAT and acting time; cells retarded at G1 phase in the cell cycle dose-dependently; and the bcl-2/bax mRNA expression in cells dawn-regulated significantly.

CONCLUSIONMAT can dose- and time-dependently inhibit the proliferation of PA-1 cell by reducing bcl-2/bax mRNA ratio to produce a G1 phase arresting in cell cycle.

Alkaloids ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Humans ; Ovarian Neoplasms ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Quinolizines ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Teratoma ; pathology ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective To investigate the value of the imaging findings of soft tissue abnormality in the differential diagnosis between osteomyelitis and malignant bone tumor.Methods The CT and MRI findings of soft tissue changes in 57 cases of osteomyelitis and 70 cases of malignant bone tumor were retrospectively defined,observed,recorded and statistically analyzed.Results In 57 cases of osteomyelitis, 54 cases were examined with CT,and soft tissue swelling was presented in 52 cases (degree Ⅰin 19 cases, degreeⅡin 16 cases,degree Ⅲin 17 cases).Abscess-like cysts in soft tissue occurred in 6 cases,masses in 5,air in 1,fat-fluid level in 1 and sinus tract in 1.Among 14 cases examined with MR imaging,soft tissue swelling was presented in all cases (degreeⅠin 2 cases,degree Ⅱin 6 cases and degree Ⅲin 6 cases). Abscess-like cysts appeared in 3 cases and showed high signal in diffusion weighted imaging, mass in Ⅰand fat-fluid level in 1.Among 54 cases examined with CT in 70 cases of malignant bone tumor, soft tissue swelling was presented in 44 cases (degreeⅠin 29 cases,degreeⅡin 12 cases,degreeⅢin 3 cases).Soft tissue masses appeared in 49 cases,bone shell and shell-like calcification in 16 cases and neoplastic bone and neoplastic calcified cartilage within soft tissue mass in 25 cases.Among 49 cases examined with MR imaging,soft tissue swelling was presented in 46 cases (degree Ⅰin 21 cases,degreeⅡin 17 cases and degree Ⅲin 8 cases),and soft tissue masses appeared in 43 cases.The degree of soft tissue swelling and the occurrence of abscess-like cyst,mass,bone shell or shell-liked calcification in the rim of mass,neoplastic bone or neoplastic calcified cartilage in masses showed significant difference(P

OBJECTIVETo evaluate the test-retest reliability of Nordic Musculoskeletal Questionnaire in nurses and to provide supplementary data for evaluating the reliability of the questionnaire in different occupational populations.

METHODSNordic Musculoskeletal Questionnaire was translated into Chinese according to the Guidelines for the process of cross-cultural adaptation of self-report measures. We carried out a study to examine the reliability of Chinese-version Nordic Questionnaire among Chinese nurses. This study was conducted in 120 nurses recruited from our hospital, who underwent questionnaire survey twice within one week. The test-retest reliability of questionnaire was analyzed.

RESULTSThe Chinese-version Nordic Questionnaire showed a high test-retest reliability, with a Kappa coefficient of 0.72∼1.00.

CONCLUSIONThe Chinese-version Nordic Questionnaire has a high test-retest reliability in nurses, so it can be used for the screening and epidemiological investigation of musculoskeletal disorders in this population.

Humans ; Musculoskeletal Diseases ; diagnosis ; Nurses ; Reproducibility of Results ; Surveys and Questionnaires