AIM: To evaluate the effect of flavored Siwu granules in the clinical adjuvant treatment for phlegm and blood stasis mutual junction retinal vein occlusion.
METHODS: Sixty patients (60 eyes) were randomly divided into treatment group and control group, both with retinal laser photocoagulation and intravitreal injection of triamcinolone acetonide, but the treatment group used flavored siwu granules. Vision, fundus change, fundus fluorescein angiography, clinical syndrome of traditional Chinese medicine ( TCM ), hemorheology examination and safety assessment were evaluated before and 8wk after treatment.
RESULTS: At 8wk after treatment, there were differences on vision improvement, retinal circulation time, whole blood low shear viscosity and total efficient rate of clinical syndrome of TCM, compared with control group(P<0. 05).
CONCLUSION: Flavored siwu granules adjuvant for phlegm and blood stasis mutual junction retinal vein occlusion can improve visual acuity and reduce the eye complications.

Adolescent ; Adult ; Aged ; Capsules ; Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glomerulonephritis ; blood ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Transforming Growth Factor beta ; blood ; Transforming Growth Factor beta1

Objective To verify the antiviral effects of Siji Kangbingdu mixture (SJKBDM) against coxsackievirus A16 (CoxA16).Methods Vero cells and 5-day-old suckling mice, injected with 75/50 and 1×106 TCID50 CoxA16, were used as evaluation models.The preventive influences of SJKBDM against CoxA16 in Vero cells were assessed in the models.The effects of SJKBDM on the mortality, survival time, change rate of body weight, and clinical symptom scores of suckling mice were observed.Results ①The half maximal inhibitory concentration of SJKBDM on Vero cells was 9.59 mg·mL-1.②Toxic effects were not observed from 32.3 g·kg-1 single dose or continuous intraperitoneal injectin of SJKBDM in suckling BALB/c mice.③The SJKBDM had significant inhibitory effect against CoxA16 virus.Doses higher than 1.22 mg·mL-1 could significantly improve the Vero cell survival rate, and the SJKBDM inhibition of 75/50 TCID50 CoxA16 induced pathological changes in Vero cells.④The SJKBDM significantly improved clinical symptoms of mice with CoxA16 viral infection, especially with crude drug doses of higher than 1.62 g·kg-1.The survival rate and other indicators were comparable or slightly higher compared with ribavirin, and the clinical score was higher than that of ribavirin.Conclusion The SJKBDM has significant inhibitory effect on CoxA16 cell proliferation, significantly decreases death rate, and improves clinical symptoms of mice infected with CoxA16 virus.

Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.

Objective To test the expression level of CD69+CD4+CD25-T cells in peripheral blood from patients with autoimmune pancreatitis,and further analyze its clinical significance.Methods Peripheral blood samples from 32 patients with AIP diagnosed in hematological department,Changhai Hospital and 32 health individuals examined at the same time were collected from September 2014 to December 2016,they were classified as experimental and control groups,separately.Peripheral blood mononuclear cells (PBMCs) was acquired by density gradient centrifugation,CD69+ CD4 + CD25-T cells in PBMCs were tested by flow cytometry,and the expression level of cytokines in plasm was by ELISA.The comparison of varies between the two groups was measured by two independent samples' t test.The relationship between the two measurement data was measured by pearson correlation coefficient.Results The expression levels of CD69 + CD4 + CD25-T in experimental and control groups were 10.36％±3.68％ vs 3.99％±1.45％ (t=9.110,P＜0.0001).The expression level of TGF-β was 399.86±121.88 vs 143.87±56.22 pg/ml (t=10.79,P＜0.000 1),both with statistical significance.The levels of CD69+CD4+CD25-T in experimental was positively correlated with TGF-β (r=0.653,P＜0.001) and negatively with IL-4,IFN-γ,IL-2 (r=-0.442,-0.567,-0.351,P＜0.05) and there was statistical significance.Conclusion CD69+CD4 +CD25-T cells might involve the immunopathology of AIP and could be the potential biomarker for clinical diagnosis and therapy.

BACKGROUNDTrans-sacral axial L5/S1 interbody fusion (AxiaLIF), a novel surgical procedure, recently adopted in clinical practice, has excellent clinical outcomes. However, there is inadequate data on the feasibility of the approach in all adult patients and the optimal surgical approach is currently unclear; therefore, further studies are required. In order to enhance the surgical approach for AxiaLIF, prospective anatomical imaging optimization is necessary. The objective of this study was to investigate the ability of magnetic resonance imaging (MRI) to achieve an optimal procedural setting.

METHODSThe subjects (n=40) underwent lumbosacral MRI examination. The median sagittal MRI images were analyzed and four measurement markers were defined as follows: the center of the L5/S1 disc (A), the anterior margin of the S1/2 disc space (B), the sacrococcygeal junction (C), and the coccygeal tip (D). The measurement markers were connected to each other to produce five lines (AB, AC, AD, BC, and BD), as reference lines for surgical approaches. The distance between each reference line and the anterior and posterior margins of the L5 and S1 vertebral bodies was measured to determine the safety of the respective approaches.

RESULTSIn all patients, Lines AB and AC satisfied the imaging safety criteria. Line AB would result in a significant deviation from the median and was determined to be unsuitable for AxiaLIF. Line AD satisfied the imaging safety criteria in 39 patients. However, the anal proximity of the puncture point proved to be limiting. For lines BC and BD, the imaging safety criteria were satisfied in 70% and 45% of patients, respectively.

CONCLUSIONSThe AxiaLIF procedure is a safe technique for insertion of fusion implants in all subjects. Line AC is a favorable reference line for surgical approach and safe for all subjects, while line BC is not suitable for all subjects.

Adult ; Aged ; Aged, 80 and over ; Fractures, Bone ; surgery ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Sacrum ; surgery ; Spinal Fusion ; methods ; Treatment Outcome

OBJECTIVETo explore the normal aerification of paranasal sinuses in Chinese children with magnetic resonance imaging.

METHODSTwo hundred and eighty Chinese children aged from 17 days to 14 years without any symptoms related to sinusitis were statistically analyzed in MRI features, including counting the number of paranasal sinus pneumatization and the maximum axial and sagittal area of the left maxillary.

RESULTSThe pneumatization rate of maxillary sinus was 85% in children aged from 0 to 1 years. Until 3 years the pneumatization rate of maxillary sinus was 95% and there was no significant difference in boys and girls (χ(2) = 0.741, P = 0.389). The pneumatization rate of maxillary sinus reached 100% after 4 years old. The pneumatization rate of ethmoid sinus was 100% in this study. The pneumatization rate of sphenoid sinus was 0 within 1 year old, 49% within 4 years old and 100% after 7 years old. There was no significant difference in boys and girls on the pneumatization rate of sphenoid sinus (χ(2) = 2.452, P = 0.117). The pneumatization rate of frontal sinus was 0 within 5 years old, 62% within 9 years old and 95% after 10 years old. There was no significant difference in boys and girls on the pneumatization rate of frontal sinus (χ(2) = 0.124, P = 0.724). The axial and sagittal maximum area of maxillary sinus was (689.28 ± 221.79) and (659.76 ± 263.31) mm(2) in girls and (668.13 ± 206.38) and (638.60 ± 207.67) mm(2) in boys. The differences were significant (t = -19.78, P < 0.001; t = -19.89, P < 0.001).

CONCLUSIONThe study of the development and normal aerification of paranasal sinuses of children can help radiologist make correct diagnosis of paranasal sinuses in children.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Paranasal Sinuses ; anatomy & histology ; growth & development

Objective: To investigate the value of early postoperative monitoring of serum albumin in the prediction of surgical site infection (SSI) in colorectal cancer surgery. Methods: A total of 169 patients undergoing colorectal cancer surgery between December 2012 and January 2016 were collected for this study. Patients was divided into SSI group and no SSI group according to whether SSI occurred after surgery. We continuously collected venous blood three days after surgery. Serum albumin, C-reactive protein level, Procalcitonin and White blood-cell were performed to evaluate the relationship between albumin changes and postoperative SSI. Results: There were 40 cases (23. 7％) of SSI, and the average time for clinical diagnosis of SSI was 3. 2 days after surgery. ALB decreased, and PCT, CRP, and WBC levels increased in the SSI group on the second postoperative day. The decrease in albumin concentration (A ALB2) was significantly higher on the second postoperative day than in the SSI group (P ＜ 0. 001). Receiver-operating characteristics (ROC) curve analysis showed that △ ALB2 had significant value in predicting the occurrence of SSI (area under the curve = 0. 864, sensitivity 97. 5％, specificity 70. 5％), and the optimal cutoff was 15. 5％. Multiple regression analysis showed that A ALB2 ＞15. 5％ was an independent predictor of SSI (OR=2. 10, 95％CI=1. 52-2. 90, P ＜ 0. 001). Conclusions: The dynamic change of serum albumin is valuable to predict the occurrence of SSI after colorectal cancer surgery.

An experimental model of reproducible focal cerebral contusions in rats was made by a free-drop impacting right hemisphere. The expression of fibronectin and its mRNA after cerebral contusion were detected respectively by immunohistochemical staining and in situ hybridization. Results indicated that the expression of fibronectin and its mRNA increased after injury, and there existed a relationship between increased fibronectin and its mRNA and different intervals after brain injury. It is inferred that the expression of fibronectin and its mRNA can be used for timing of brain injuries and distinguishing antemortem and postmortem brain contusions.
Animals ; Brain Injuries/metabolism* ; Fibronectins/biosynthesis* ; Immunohistochemistry ; In Situ Hybridization ; Male ; Postmortem Changes ; RNA, Messenger/biosynthesis* ; Rats ; Rats, Sprague-Dawley ; Time Factors

OBJECTIVETo investigate the clinical results of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spinal stenosis with lumbar instability.

METHODSRetrospective study was done on 42 cases of lumbar spinal stenosis with lumbar instability treated with bilateral decompression via unilateral approach and MIS-TLIF through an expandable tubular retractor from March 2010 to January 2011. There were 18 males and 24 females, and mean age was 61.7 years (rang, 48 - 79 years). The level of surgery was L(3-4) in 4 patients, L(4-5) in 26 patients, and L(5)-S(1) in 12 patients. All patients had symptoms of intermittent claudication. And 24 patients had symptoms of lower extremity pain and numbness in one side, and 18 patients had same symptoms in both legs. Operation time, intra-operative bleeding, postoperative hospital stay and complications were recorded. Visual analogue scale (VAS) scores for low back pain and leg pain were recorded before and after surgery. Oswestry disability index (ODI) scores were also recorded before and after surgery. The Bridwell criterion was used for evaluating the interbody fusion, and the MacNab criterion was used for assessment after surgery.

RESULTSThe mean operative time was 150.4 minutes (range, 120 - 170 minutes), and mean blood loss was 147.1 ml (range, 50 - 400 ml). The hospitalization time after surgery was 5 - 18 d, an average of 8.8 d. All cases were followed-up for 6 - 14 months (average 11 months). VAS score of low back pain before surgery was 7.3 ± 1.0, and were 2.9 ± 0.8 and 2.0 ± 0.8 at three months after surgery and the last follow-up respectively. VAS score of leg pain before surgery was 7.9 ± 0.7, and were 2.0 ± 0.5 and 1.0 ± 0.7 at three months after surgery and the last follow-up respectively. ODI score was 75% ± 6% before surgery, were 16% ± 6% and 12% ± 5% at three months after surgery and the last follow-up respectively. VAS and ODI scores showed statistically significant improvements (t = 3.110 - 56.323, P < 0.01). There were 40 cases were grade I and II, according to the Bridwell criteria. The clinical results were excellent in 16 cases, good in 22 cases and fair in 4 cases to the MacNab criteria at the final follow-up.

CONCLUSIONSMIS-TLIF is an ideal surgical method for single segment lumbar spinal stenosis with lumbar instability, but close attention should be paid to specific patients, surgeons and hospitals.

Aged ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Spinal Diseases ; surgery ; Spinal Fusion ; methods ; Spinal Stenosis ; complications ; surgery