Objective To investigate the clinical features and mechanism and feasibility of plasma exchange (PE) in treating systemic lupus erythematosus (SLE) complicated with acute pancreatitis (AP). Methods A retrospective analysis of SLE associated with AP was done based on the HIS in Tongji Hospital. Totally 24 SLEAP patients were admitted to Tongji hospital from March 2006 to May 2014. Patientsˊ serum amylase, lipase and interleukin (IL)-6 concentration were measured before and after plasma exchange. According to different therapy strategy, patients were divided into two groups. Fifteen patients treated with plasma exchange combination with glucocorticosteroid (GC) were classified as Group A, the other 9 patients who were treated with GC only were classified as group B. At baseline and after treatment, the serum lipid concentration, average daily glucocorticosteroid dosage between group A and B were compared with ANOVA and serum IL-6 concentration between roup A and B were compared with Wilcoxon rank test. Results SLEDAI score in group A patients at baseline (16 ±5) was no statistically different from that in group B (18 ±4) (t=1.31, P=0.320). Average daily GC dosage in group A 31.0 (20.50, 30.08)mg/d was significantly less than that in group B 47.85 (45.58, 59.23) mg/d (Z=35.50, P= 0.002). Serum IL-6 levels in group A and B at baseline was not significantly different 13.14 (11.12,16.57) mg/L vs 14.63 (11.37, 16.37) mg/L (Z=12.20, P=0.300), after 2 weeks treatment, IL-6 level, which was 9.16 (7.93, 10.75) mg/L, decreased significantly in group A while it didnˊt show tendency of decrease in group B, which was 13.62(9.29, 17.63) mg/L (Z=28.50, P=0.039). Serum lipid concentration after 2 weeks therapy in Group A [TC=(5.02 ±0.53) mmol/L, TG=(1.46 ±0.44) mmol/L] decreased significantly compared to baseline [TC=(6.11±0.50) mmol/L, TG=(2.14±0.65) mmol/L] (F=4.46, P=0.010; F=6.09, P=0.002), while similar tendency wasnˊt observed in group B (F=1.57, P>0.05). Conclusion PE combined with GC could lower serum IL-6 levels, reduce the amount of GC and lower serum lipid to improve prognosis. Therefore it might be a safe and effective way and is worthy of continuing to explore its feasibility.

BACKGROUND:Transforaminal lumbar interbody fusion(TLIF)can be applied in any lumbar segment,and retain integrity of lateral vertebral plate and zygapophysiai joints.However,few studies have been conducted about the biomechanical performance.OBJECTIVE:To explore the stability of lumbar intervertebral segment following TLIF appHed bilateral and unilateral transpedicular screws fixation.DESIGN,TIME AND SETTING:Biomechanical test was performed at the Institute of Biomechanics,Shanghai University and Nantong University between August 2005 and April 2006.MATERIALS:Twenty samples of fresh one-month-old calf lumbar vertebra.METHODS:Twenty samples of calf lumbar vertebra underwent TLIF alone,TLIF in combination with bilateral or unilateral transpedicular screws fixation.Biomechanical test was performed on spinal three dimensional motion testing machine.MAIN OUTCOME MEASURES:Stress,displacement.strain and torsion angle were recorded.RESULTS:After TLIF without fixation.no obvious changes were found in mean stress and strain,but the axes stiffness and rotational stiffness were significantly decreased,indicating TLIF could produce immediate lumbar stability.After TLIF with unilateral or bilateral transpedicular screws fixation,the lumbar stability was significantly enhanced compared with TLIF alone,especially bilateral transpedicular screws fixadon.Although the lumbar stability following unilateral transpedicular screws fixation was inferior to bilateral fixation,it was still greatly enhanced,even bxceeded normal sample,indicating TLIF with unilateral transpedicular screws fixation could produce enough initiallumbar stability.CONCLUSION:TLIF alone cannot support sufficient initial stability,but TLIF with bilateral and unilateral transpedicular screws fixation can enhance lumbar initial stability.

Purpose Lipotoxicity plays an important role in the progression of diabetes and its complications,and the gold standards for organs' lipid quantification are biopsy or histochemical staining,which are invasive and have their own limitations.Thus,our research was to identify the difference in organ lipid deposition between type 2 diabetic patients and healthy volunteers by using noninvasive three-point T2* corrected Dixon imaging.Materials and Methods Sixty-five type 2 diabetic patients and 34 healthy volunteers were included in this study.All participants underwent three-echo Dixon with 3.0T MR imager.Dixon imaging parameters [hepatic fat fraction (HFF),splenic fat fraction (SFF),pancreatic fat fraction (PFF)] were collected.All of the MRI parameters were compared.The relationship between HFF,SFF,PFF and BMI,age were analyzed.Results The hepatic and splenic lipid percentage in diabetic group [HFF=(5.4±4.3)％;SFF=(3.7± 1.4)％] was significantly higher than healthy volunteers group [HFF=(2.9± 1.3)％;SFF=(3.0± 0.9)％;P＜0.05,respectively].However,there was no significant difference in pancreatic fat fraction between diabetic and healthy groups (P＞0.05).There were positive correlations between HFF,SFF,PFF and BMI (r=0.379,0.305 and 0.306,P＜0.05).Moreover,only the positive correlation between pancreatic fat fraction and age were observed (r=0.261,P＜0.05).Conclusion The three-point T2* corrected Dixon revealed the abnormalities of hepar and spleen lipid accumulation in diabetic patients.Thus,the three-point Dixon imaging may potentially aid in evaluating the lipid deposition of abdominal organs.

Objective:To explore the anti-tumor effect of Tanshinone Ⅱ A microemulsion and to research its reversal effect of multidrug resistance on SMMC-7721/VCR tumor.Methods The human hepatocellular carcinoma cell line SMMC-7721 and human hepatocellar carcinoma drug-resisitant cell line SMMC-7721/VCR were cultured in vitro.Each cell was divided three groups:experimental group (cell suspension + 3 kinds of anti-tumor drugs),negative control group (cell suspension + culture) and blank control group (culture).Tanshinone Ⅱ A microemulsion and Tanshinone Ⅱ A in five concentrations (0.5,1.0,2.0,4.0,8.0 μg · mL-1) intervention SMMC-7721 cells.The inhibition effect of Tanshinone Ⅱ A microemulsion of 0.5,1,2,4,8 μg · mL-1 in 24 h and 48 h on SMMC-7721 cell proliferation was tested by MTT assay.The IC50 of VCR,CDDP,5-fluorouracil(5-Fu) for the cell of SMMC-7721,SMMC-7721/VCR were determined by MTT assay.The IC50 of VCR,CDDP,5-Fu for the SMMC-7721/VCR after intervention with Tanshinone Ⅱ A microemulsion were determined also by MTT assay.The sensitivity change and drug reversal effect of Tanshinone Ⅱ A microemulsion before and after intervention on the SMMC-7721/VCR cell line was investigated by MTT assay.Results The inhibition rate after intervention with Tanshinone Ⅱ A microemulsion on SMMC-7721 cells for 48 h were 47.93％,55.92％,66.34％,95.61％.Accordingly,the inhibition rate of Tanshinone Ⅱ A were 38.83％,49.31％,58.24％,82.46％.The half inhibitory concentration were (0.67 ±0.32),(1.91 ±0.53) μg · mL-1,respectively.The difference had statistical significance (all P ＜ 0.01).With the increase of concentration,the inhibition rate increased of Tanshinone Ⅱ A microemulsion on SMMC-7721 cell with dose dependence and time dependence.When the concentration of Tanshinone ⅡA and its microemulsion for 0.5 ug · mL-1,on SMMC-7721 cells and SMMC-7721/VCR cell growth inhibition rate were 9.53％,7.74％,both less than 10％ and no obvious toxic effect,so concentration of 0.5 μg · mL-1 was choosed as liver cancer drug resistant safety experiment dose.When 0.5 ug · mL-1 Tanshinone Ⅱ A microemulsion was intervention on SMMC-7721/VCR cell,VCR to SMMC-7721/VCR half inhibitory concentration was from (12.27 ±0.84) ug · mL-1 to (3.25 ±0.14) ug · mL-1.Reverse ratio is 3.78.Half inhibitory concentration of CDDP on SMMC-7721/VCR cell is from (20.42 ± 0.18) μg · mL-1 to (6.98 ±0.99) μg · mL-1,reverse ratio is 2.93.Half inhibitory concentration of 5-FU on SMMC-7721/ VCR cell is from (35.21 ± 0.68) μg · mL-1 to (18.27 ± 2.18) ug · mL-1;reverse ratio is 1.93.Compared with the effect on SMMC-7721 ceils,VCR,CDDP,5-FU effect on SMMC-7721/VCR cells had significant difference (P ＜0.01).Compared with the effect on SMMC-7721/VCR cell which was dealed by Tanshinone Ⅱ A microemulsion,VCR,CDDP,5-FU effect on SMMC-7721/VCR cells had significant difference (P ＜ 0.01).Conclusion The Tanshinone Ⅱ A submicroemulsion can inhibit the growth of SMMC-7721 cells and SMMC-7721/VCR cells.The Tanshinone Ⅱ A submicroemulsion can partially reverse the multidrug resistance of SMMC-7721/VCR in vitro.

OBJECTIVETo research on the main pattern of hepatic cells death during hepatic ischemia/ reperfusion (I/R) injury in cirrhotic rat.

METHODSCirrhotic rat model was established by carbon tetrachloride replication. These rats were randomly divided into sham operation group and I/R group. In the I/R group, 70% i/R injury model was established and then the liver samples were taken 0, 1, 6, 24, and 48 hours after reperfusion. Serum alanine aminotransferase (ALT)/aspartate aminotransferase (AST) levels, Na+ - K+ ATPase, and Ca2+ ATPase were compared. the percentage of apoptotic/oncotic hepatic cells was measured with flow cytometry, and the changes in hepatic cellular structures were observed under transmission electron microscope.

RESULTSCompared with the sham operation group, the levels of serum AST and ALT significantly increased in the I/R group (P < 0.05), reaching their peak levels at the 6th hour. The activities of Na+ - K+ ATPase and Ca2+ ATPase dramatically decreased one hour after reperfusion and then gradually recovered (P < 0.05). Hepatic cells mainly suffered oncosis at the early stage after reperfusion (within 6 hours); at the late stage (around 24 hours after reperfusion), apoptosis became the main death pattern.

CONCLUSIONOncosis is the main pattern of hepatic cells death during I/R injury in cirrhotic rat, and the severity of hepatic injury correlates with the oncosis.

Alanine Transaminase ; blood ; Animals ; Apoptosis ; Aspartate Aminotransferases ; blood ; Disease Models, Animal ; Humans ; Liver Cirrhosis ; blood ; physiopathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Reperfusion Injury ; blood ; physiopathology

OBJECTIVETo analyze the epidemiological conditions and characteristics of inpatients with traffic trauma in order to provide objective data for basic research and clinical application of traffic trauma.

METHODSThe data of 2213 inpatients with traffic trauma admitted to Lihuili Hospital, Ningbo Medical Centre, Ningbo, China, from January 2003 to September 2005 were studied retrospectively. According to the transportation ways, the patients were divided into four groups: pedestrians, bicyclists, motorcyclists, and automobilists. And the data of injured regions, combined injuries and causes of death were analyzed statistically.

RESULTSAmong the 2213 patients, there were 550 pedestrians (23.5%), 521 bicyclists (24.9%), 738 motorcyclists (33.3%), and 404 automobilists (18.3%). Male patients were more than female ones, with the ratio of male to female of 2.8:1. Single region injury was found in 1663 patients (75.15%) and multiple injuries in 550 patients (24.85%). In total, 2849 regions were injured. Fracture of extremities (53.3%) occurred most often, craniocerebral trauma (19.4%) next, then followed in turn by thoraco-abdominal visceral injury (6.56%), spine fracture (5.37%), fracture of ribs (4.88%), and pelvic fracture (4.18%). The percentage of multiple injuries (33.2%) was highest and the percentage of thoraco-abdominal injury (18.0%) was higher in motorcyclists. The percentages of craniocerebral trauma in pedestrians and bicyclists were 27.8% and 28.2%, respectively. The incidence of fracture of extremities in motorcyclists reached 73.8%, but with the lowest case-fatality ratio of 1.4%. The incidence of traffic accidents caused by motorcyclists themselves (32.8%) was highest. A total of 56 patients died, with the case-fatality ratio of 2.53%. Among the deaths, 47 died from craniocerebral injury, 6 from multiple fractures combined with hemorrhagic shock, 2 from combined injury in the thoraco-abdominal region, and 1 from cervical cord injury.

CONCLUSIONSNowadays, the patients with traffic trauma are mainly pedestrians, bicyclists and motorcyclists, and they suffer generally from fracture of extremities and craniocerebral injury. The main cause of death is craniocerebral injury. Another characteristic of traffic trauma is that the ratio of multiple injuries is higher.

Accidents, Traffic ; statistics & numerical data ; Adult ; China ; epidemiology ; Female ; Fractures, Bone ; epidemiology ; Humans ; Male ; Middle Aged ; Multiple Trauma ; epidemiology ; Retrospective Studies ; Shock, Hemorrhagic ; epidemiology ; Wounds and Injuries ; epidemiology

Aged ; Fatal Outcome ; Heart Rupture ; etiology ; Humans ; Male ; Myocardial Infarction ; therapy

OBJECTIVETo investigate a novel technique for new bone formation--periosteal distraction osteogenesis.

METHODSA custom made periosteal distraction device was fixed to bilateral surface of the mandible in three rabbits. Periosteal distraction was performed on the left side of the mandible, the right side of the mandible served as the control. The animals were sacrificed at the end of distraction process. All the specimens were X-rayed and histologically examinated.

RESULTSAll three animals survived with no obvious complications. Both in mass specimens and X-rays, there showed new bone formation on the distracted side of the mandible. In histological examinations, there was osteoblast-like cell infiltration and bone tissue formation in the distracted area.

CONCLUSIONPeriosteal distraction osteogenesis can provide a novel technique for the repair of bone defects.

Animals ; Mandible ; Osteoblasts ; Osteogenesis ; Osteogenesis, Distraction ; Rabbits

OBJECTIVETo evaluate the clinical effect of the disk-up sinus reamer (DSR) applied to transcrestal maxillary sinus floor elevation with simultaneous placement of implants.

METHODSThirty-seven patients underwent transcrestal maxillary sinus floor elevation with fifty-one implants placed simultaneously using the DSR. The residual bone height (RBH) was 3 to 8 mm, (5.61 ± 1.61) mm on average. The safety of this technique and the pain index during the operation was evaluated. The final prostheses were restored in 3-6 months postoperatively. The follow-up period was 3 to 24 months. The stability and osseointegration of the implants were clinically evaluated, and the endo-sinus bone gain around the implants were measured.

RESULTSThe elevation height ranged from 2 to 8 mm, with an average of (4.75 ± 1.55) mm. There was no detectable sinus membrane perforation, no serious suffering or uncomfortable subjective sensation in any patients during operation with a pain index of (2.22 ± 0.98). During the follow-up period, no sinus complication was observed. Favorable osseointegration was obtained. There were no implants or prostheses which were loose or lost. The survival rate was 100%. The radiographic results demonstrated that the endo-sinus bone gain tended to reach stabilization after 6 months and the marginal bone loss was (1.20 ± 0.72) mm after 12 months.

CONCLUSIONSTranscrestal maxillary sinus floor elevation with simultaneous implant placement by DSR is a safe, invasive and handy technique, with higher elevation height, fewer clinical complications and less pain. It shows satisfactory clinical results in short term and a long-term observation is still needed.

Adult ; Aged ; Dental Implantation, Endosseous ; Dental Implants ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; diagnostic imaging ; surgery ; Middle Aged ; Osseointegration ; Pain Measurement ; Radiography, Panoramic ; Sinus Floor Augmentation ; instrumentation ; methods ; Tooth Loss ; diagnostic imaging ; surgery ; Treatment Outcome ; Young Adult

Angina Pectoris, Variant ; diagnostic imaging ; Coronary Angiography ; Coronary Vessel Anomalies ; diagnostic imaging ; Female ; Humans ; Middle Aged ; Ultrasonography, Interventional