OBJECTIVETo observe the clinical efficacy of Wangbi Tablet (WT) on the treatment of knee osteoarthritis (KOA), and to study its treatment program by integrative medicine.

METHODSThe randomized, parallel control, and multi-center clinical observation method was used. 160 KOA patients of Gan-Shen deficiency complicated with stasis-blood blockade syndrome were assigned to three groups. Group A (72 cases) was treated by WT, Group B (42 cases) was treated by Votalin Tablet, and Group C (46 cases) was treated by WT + Votalin Tablet. All patients were treated for two months. Before and after treatment the clinical symptoms, the knee function activity, adverse reactions were observed and recorded. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of each patient were respectively detected, statistically analyzed and compared.

RESULTSAfter eight weeks of treatment significant difference was shown in the time of morning stiffness in joints, joint tendemess, swelling, pain, joint functional activities, ESR, and CRP between Group A and Group B (P<0.01). Besides, better effects were obtained in Group C (P<0.01). Improvement of ESR and CRP: They were obviously improved in the three groups after treatment (P<0.01). As for the markedly effective rate, better effects were obtained in Group C (P<0.05).

CONCLUSIONSIn the treatment of KOA, WT showed favorable effects with no obvious adverse reaction. The combination of WT and Voltaren Tablet was significantly superior to use of WT or Votalin Tablet alone. It could reduce the dosage of Voltaren Tablet and avoid adverse reactions of the gastrointestinal tract.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Phytotherapy ; Tablets

Objective To investigate the dynamic changes of the spinal cord during neck flexion in Hirayama disease for diagnosis.Methods MRI examinations in neutral neck position and a fully flexed neck position were performed on 18 cases of Hirayama disease and 31 young normal control subjects.We measured an antero-posterior diameter(APD)and transverse diameter(TD)of the cervical cord at the superior margin of the C6 vertebral body for each position,and investigate the dynamic changes.The different in frequency of these findings between the control and patient groups was examined by means of the x~2 test.The group means were compared by independent-sample t-test.Significance was defined as P

Objective To evaluate the diagnostic value of the level of plasma D-dimer, lipoproteins and carcino-embry-onic antigen(CEA) in gastrointestinal cancer.Methods The plasma D-dimer ,lipoproteins,CEA and clinicopathological data of 139 gastrointestinal cancer patients and 155 normal controls were collected and analyzed .Lipoproteins included high-density lipoprotein(HDL),low-density lipoprotein(LDL) and lipoprotein a[LP(a)].SPSS 13.0 statistical software was used to analyze the sensitivity and specificity of each examination method and to find the appropriate combination .Results The plasma D-dimer,LDL,LP( a) and CEA levels were distinctly higher in patients than those in normal controls ( P<0.001).HDL levels were significantly lower in patients than those in normal controls (P<0.001).The cutoff of D-dimer was 0.495 μg/ml , the sensitivity of D-dimer was 62.6%,and the specificity was 86.5%.The cutoff of HDL was 1.025 mmol/L, the sensitivity was 72.7%,and the specificity was 85.2%.The cutoff of LDL was 3.375 mmol/L, the sensitivity was 54%,and the specificity was 82.6%.The cutoff of LP(a) was 27.3 mg/dl, the sensitivity was 58.3%,and the speci-ficity was 87.1%.The cutoff of CEA was 2.14 ng/ml, the sensitivity was 59.7%,and the specificity was 76.8%.The sensitivity and specificity of HDL +CEA were 77.7%and 88.4%, respectively.The sensitivity and specificity of HDL +D-dimer were 70.5% and 96.1%, respectively.The sensitivity of HDL +LP(a) was 76.3%,and the specificity was 93.5%.The sensitivity of D-dimer +HDL+LP(a) was 84.2%,and the specificity was 92.3%.The sensitivity of D-dimer +HDL+CEA was 87.1%, and the specificity was 85.8%.The sensitivity and specificity of HDL +LP(a) +CEA were 85.6%and 92.3%, respectively.The sensitivity of D-dimer +HDL+CEA +LP(a) was 89.9%while the specificity was 92.3%.Conclusions Plasma D-dimer and lipoproteins can serve as tumor markers in gastrointestinal cancer .Combined detection has higher sensitivity and specificity .

OBJECTIVETo explore the molecular mechanism of pain associated with chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) in the rat model of prostatic inflammation.

METHODSThirty-six male SD rats were equally randomized to an experimental and a control group, the former injected with 50 μl of 3% λ-carrageenan into the ventral prostate to make the model of non-bacterial prostatic inflammation, while the latter with the same volume of sterile saline solution. At 1, 2 and 4 weeks after modeling, the prostate, L6-S1 dorsal root ganglion (DRG) and spinal cord were harvested for examination of the expressions of the nerve growth factor (NGF), transient receptor potential ankyrin 1 (TRPA1), and calcitonin-gene-related peptide (CGRP) by immunohistochemistry and Western blot.

RESULTSThe expressions of NGF, TRPA1 and CGRP in the prostatic tissue were all significantly increased in the experimental group as compared with the control (P <0.05), with a gradual decrease with the prolonging of time (P <0.05). In the L6-S1 DRG and spinal cord, the expressions of NGF, TRPA1 and CGRP exhibited no significant differences between the experimental and control groups at 1 week after modeling (P >0.05) and kept at high levels in the experimental group at 2 and 4 weeks, though not significantly different from those at 1 week (P >0.05). Statistically significant differences were observed in the expressions of the three proteins in the experimental rats among different time points (P <0.05), but not between the two groups at any time point (P >0.05).

CONCLUSIONThe molecular mechanism of CP/CPPS can be evaluated in the rat model of prostatic inflammation established by injecting λ-carrageenan into the prostate. TRPA1 may play an important role in connecting the upstream and down-stream pathways of CP/CPPS-associated pain.

Animals ; Calcitonin Gene-Related Peptide ; metabolism ; Carrageenan ; Chronic Disease ; Chronic Pain ; metabolism ; Ganglia, Spinal ; metabolism ; Humans ; Male ; Nerve Growth Factor ; metabolism ; Pelvic Pain ; metabolism ; Prostatitis ; chemically induced ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; metabolism ; TRPA1 Cation Channel ; TRPC Cation Channels ; metabolism

OBJECTIVETo investigate the efficacy and mechanism of Fengshikang (FSK) in treating rheumatoid arthritis (RA).

METHODSThirty-eight patients with RA of damp-heat block syndrome type in Chinese medicine (CM), were randomized into two groups. They all received glucocorticoid therapy for 1 month, but FSK was administered to the 20 patients in the CM group in addition, while to the 18 in the WM group, MTX was given. Besides, a normal control group with 20 healthy subjects was set up. Blood levels of RA related indices were measured and compared.

RESULTSAfter treatment, the levels of rheumatoid factor (RF) and C-reactive protein (CRP) were significantly reduced in both groups (P<0.05), but the reduction was more significant in the CM group (P<0.05). No significant change was found in the level of ESR after treatment and showed no significant difference between groups (P>0.05). Both hGRalpha mRNA and hGRbeta mRNA expressions were significantly higher in the patients than in the normal controls (P<0.01), they were lowered after treatment in the CM group (P<0.01), but significant reduction could only be found in level of hGRbeta mRNA in the control group (P<0.01).

CONCLUSIONFSK combined with glucocorticoid can effectively control the inflammatory reaction, decrease the level of hGRalpha and hGRbeta expressions and enhance the clinical efficacy in treating RA.

Adult ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Middle Aged ; Phytotherapy ; RNA, Messenger ; genetics ; metabolism ; Receptors, Glucocorticoid ; genetics ; metabolism ; Young Adult

OBJECTIVEMeasurement of biomarkers is a potential approach to early prediction of the risk of mortality in patients with sepsis. The aim of the present study was to evaluate the prognostic value of pro-atrial natriuretic peptide (pro-ANP) and pro-adrenomedullin (pro-ADM) levels in a cohort of medical intensive care patients and to compare it with that of other known biomarkers and physiological scores.

METHODSBlood samples of 51 consecutive critically ill patients admitted to the intensive care unit and 53 age-matched healthy control people were evaluated in this prospective study. The prognostic value of pro-ANP and pro-ADM levels was compared with that of acute physiology and chronic health evaluation (APACHE) II scores and various biomarkers such as C-reactive protein, interleukin-6 and procalcitonin. Pro-ANP and pro-ADM were detected by a new sandwich immunoassay.

RESULTSOn admission, 25 patients had systemic inflammatory response syndrome (SIRS), 12 sepsis, 9 severe sepsis and 5 septic shock. At that time, the median levels (ng/ml) of pro-ANP and pro-ADM were 87.22 and 0.34 respectively in patients with SIRS, 1533.30 and 2.23 in those with sepsis, 1098.73 and 4.57 in those with severe sepsis, and 1933.94 and 8.21 in those with septic shock. With the increasing severity of disease, the levels of pro-ANP and pro-ADM were gradually increased. On admission, the circulating levels of pro-ANP and pro-ADM in patients with sepsis, severe sepsis, or septic shock were significantly higher in non-survivors than in survivors (P less than 0.05). In a receiver operating characteristic curve analysis for the survival of patients with sepsis, the areas under the curve (AUCs) for pro-ANP and pro-ADM were 0.89 and 0.87 respectively, which was similar to the AUCs for procalcitonin and APACHE II scores.

CONCLUSIONPro-ANP and pro-ADM are valuable biomarkers for prediction of severity of septic patients.

APACHE ; Adolescent ; Adrenomedullin ; blood ; Adult ; Aged ; Atrial Natriuretic Factor ; blood ; C-Reactive Protein ; analysis ; Female ; Humans ; Male ; Middle Aged ; Protein Precursors ; blood ; Sepsis ; blood ; Shock, Septic ; blood

OBJECTIVETo evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures.

METHODSClinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74.88 ± 4.38) years old ranging from 70 to 86. According to Evans types, 4 cases were type I, 5 cases were type II, 13 cases were type III, 11 cases were type IV, 1 case was type V. Seventy-two patients were treated with conventional trauma method (conventional group), including 35 males and 37 females with an average age of (74.46 ± 3.63) years old ranging from 70 to 85. According to Evans type, 8 cases were type I ,13 cases were type II, 25 cases were type III, 25 cases were type IV, and 1 case was type V. All fractures were treated with proximal femoral nails anti-rotation (PFNA). Operative time, hospital stays, leaving bed time, complications, cases of death at 1 year after operation, postoperative Harris score at 12 months were observed and compared.

RESULTSAll patients were followed up, the time of ETC group ranged from 9 to 18 months with an average of 13.29 ± 1.51, and the time in conventional group ranged from 12 to 16 months with an average 12.93 ± 1.15, while there was no significant difference between two groups in time of following-up (t = 1.368, P = 0.174). There was no significant meaning in cases of death between ETC group (2 cases) and conventional group (8 cases). Three cases occurred complications in ETC group, and 20 cases in conventional group,there was obvious meaning between two groups (χ² = 0.739, P = 0.318). Operative time,hospital stays,leaving bed time in ETC group respectively was (2.03 ± 0.67) d, (15.41 ± 2.87) d and (3.62 ± 0.74) d; while in conventional group respectively was (4.17 ± 1.59) d, (20.11 ± 4.24) d and (5.35 ± 1.22) d; there were significant differences between two groups in operative time, hospital stays, leaving bed time. Postoperative Harris scores at 12 months in ETC group was (82.32 ± 4.56), and (79.24 ± 5.52) in conventional group, there was obvious meaning between two groups (t = 2.833, P = 0.006).

CONCLUSIONETC pattern is a novel method for diagnosis and treatment of intertrochanteric femur fractures in elderly, it could shorten operative time, hospital stays, leaving bed time, decrease complications and promote recovery of function.

Aged ; Aged, 80 and over ; Female ; Femur ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Hospitalization ; Humans ; Male ; Operative Time ; Postoperative Care ; Retrospective Studies

Objective To evaluate the role of imaging diagnosis in surgical treatment of primary aldosteronism(PA). MethodsFrom Jan 1995 to Dec 2004,245 patients with PA were hospitalized in our hospital.Before the operations,all the patients underwent B-ultrasonography and CT scaning,240 received intravenous pyelography and 75 MRI.The preoperative imaging diagnosis were compared with the findings during the operations and postoperative pathologic results. Results Compared with the findings during the operations,the accuracy rates of localized diagnosis for PA with B-ultrasonography,CT scanning and MRI were 92.7%,98.2% and 90.4%,respectively.Compared with the postoperative pathologic results,the accuracy rates of qualitative diagnosis for aldosterone-producing adenoma(APA) with B-ultrasonography,CT scanning and MRI were 83.0%,90.7% and 72.2%,respectively. Conclusion The comprehensive imaging data are helpful in the localized diagnosis of PA.Correct preoperative qualitative diagnosis of APA is the key step for the surgical treatment for PA.

Objective To discuss how to protect the intracranial vertebral artery and posterior inferior cerebellar artery by observing and measuring the intracranial vertebral artery in the surgery adopt far lateral approach. Methods Mimicking far lateral approach, 20 adult cadaveric heads connected to neck fixed with 10% formalin were dissected. Intracranial segment of the vertebral arteries and their main branches were exposed and measured under operating microscope. Results The intracranial vertebral artery joined with the contralateral one into the basilar artery after traveling through the atlanto-occipital sulcus. The relationship between the vertebral artery and the hypoglossal nerve is close. Thirty sides (75%) of the vertebral arteries traveled to pons medulla sulcus in front of the hypoglossal nerve roots and 2 sides (5%) behind the hypoglossal nerve roots, while 8 sides (20%) traveled among the hypoglossal nerve roots; 70% of the vertebral arteries were contacted to the hypoglossal nerve roots, 30% of which compressed the hypoglossal nerve. The main branches of intracranial segment of the vertebral arteries were the posterior inferior cerebellar arteries, the anterior spinal arteries, the posterior meningeal arteries,and some perforating arteries. Posterior inferior cerebellar arteries all originated from the intracranial vertebral artery were the largest vertebral artery's branches; their trip was mostly loop-shaped and they had close relationship with Ⅸ, Ⅹ, Ⅺ cranial nerves. The starting points of the posterior inferior cerebellar arteries were different, even in the same specimen, but most of them originated from the upper 1/3intracranial vertebral artery. No anterior inferior cerebellar artery was noted originated from the vertebral artery in our specimen. Anterior spinal arteries originated from the vertebral arteries joined with the branches of the bilateral vertebral arteries and traveled down through the tortuous anterior median fissure to supply the spinal cord. Conclusion Being familiar with the characteristics and anatomic vertebral arteries variations of the intracranial vertebral artery and its branches can contribute to identify and protect the intracranial segment of the vertebral artery and its main branches in the surgery adopt far-lateral approach.

OBJECTIVETo investigate the characteristics of inhibitory and activating receptor expressions on natural killer (NK) cells in HIV/HCV co-infected patients.

METHODSNumbers, frequencies and expressions of activating and inhibitory receptors of NK cells were measured with flow cytometry (FCS) from HIV/HCV co-infected group (n = 24), HCV mono-infected group (n = 34), HIV mono-infected group (n = 21) and healthy control group (HC, n = 20), then analysis and compare were performed among those groups.

RESULTSThe NK cell absolute counts in HIV/HCV group were significantly lower than those in other three groups. The NKP30 and NKP46 frequencies on NK cells in HIV/HCV, HIV and HCV groups were all significantly lower than those in HC group, but there were no significant differences of NKP30 among former three groups; and NKP46 frequencies in HIV/HCV and HIV groups were lower than those in HCV group, but there were no significant differences between former two groups. The NKG2A frequencies in HIV/HCV and HCV groups were all higher than those in HIV and HC groups significantly, but the NKG2A frequencies in HIV group were lower than those in HC group; There were no significant differences of NKG2D, CD158a and CD158b among those four groups.

CONCLUSIONNK cell numbers and expressions of activiting receptors on NK cells obviously decreased in HIV/HCV co-infected patients, but some inhibitory receptors expressions increased, even higher than those of HIV mono-infected patients. NK cells impairments in HIV/HCV co-infection is more severe than HIV or HCV mono-infection.

Adult ; Female ; Flow Cytometry ; HIV Infections ; genetics ; metabolism ; Hepatitis C ; genetics ; metabolism ; Humans ; Killer Cells, Natural ; metabolism ; Male ; Middle Aged ; NK Cell Lectin-Like Receptor Subfamily C ; genetics ; metabolism ; NK Cell Lectin-Like Receptor Subfamily K ; genetics ; metabolism ; Natural Cytotoxicity Triggering Receptor 1 ; genetics ; metabolism ; Natural Cytotoxicity Triggering Receptor 3 ; genetics ; metabolism ; Receptors, KIR2DL1 ; genetics ; metabolism ; Receptors, KIR2DL3 ; genetics ; metabolism ; Young Adult