Seventy eight patients who need bedside temporary cardiac pacing through left subclavian vein were divided into 2 groups. In group A (n=40) the "three-point measurement" method was applied: a was set for puncture point of left subclavian vein, b was the middle point of angulus sterni, c was the right edge of the sternum at the 4th intercostal space, the length of ab + bc was used to estimate the depth of right atrium for electrode to reach until the success of right ventricular pacing. In group B (n=38) the puncture to the right or the left subclavian vein for temporary pacing was performed with X-ray guidance in catheter lab. Total rescuing time, procedure time and the threshold voltage of cardiac pacing was recorded in each groups. All cases were successful paced without complication related emergency cardiac pacing with a successful rate of 100% in both groups. There was not difference between two groups in the procedure time and the threshold voltage of cardiac pacing (P > 0. 05). The total rescuing time of A group was (10.0± 2.2) min, and that of B group was (30.5±3.5) min (P<0.01). The average depth of the electrode was ab + bc +9.0 cm. The results suggest that "three-point measurement" method is valuable in the guiding of bedside emergent cardiac pacing through the left subclavian vein.

This paper briefly analyzes the bottlenecks and major technical requirements for pharmaceutical industry of Chinese medicine, providing current status of pharmaceutical engineering of Chinese medicine. The innovation directions and strategies of the pharmaceutical engineering for manufacturing Chinese medicine are proposed along with the framework of their core technology. As a consequence, the development of the third-generation pharmaceutical technology for Chinese medicine, featured as "precision, digital and intelligent", is recommended. The prospects of the pharmaceutical technology are also forecasted.
China ; Drug Industry ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; standards ; Medicine, Chinese Traditional ; methods ; standards ; Quality Control

BACKGROUNDSurgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is critical, besides excision of the bursitis and the calcaneal exostosis. Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon. For Achilles tendon reconstruction if detachment is present, several surgical techniques have been reported. Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon. The SutureBridge double-row construct, initially used in rotator cuff repair, is probably a good choice.

METHODSTen consecutive patients with insertional Achilles tendinopathy underwent tendon reattachment using the SutureBridge technique through a central tendon-splitting approach. We retrospectively evaluated the surgical outcomes, which included pre- and postoperative visual analog scale (VAS), postoperative Maryland Foot Score (MFS), postoperative range of motion of the affected ankle, and related complications. Follow-up was performed in the outpatient department.

RESULTSOne patient was lost to follow-up. Nine patients (two male and seven female; 12 feet) were reviewed with a minimum follow-up of six months (range 6-30 months). The postoperative VAS pain scores were markedly lower than the preoperative scores. Postoperative MFS was 92.1±8.0 (range 74-100). No intra- or postoperative complications were found, except for one case of delayed healing incision. At last follow-up, all affected ankles achieved their normal range of motion, and patients were able to resume daily activities without any assistive device.

CONCLUSIONSAlthough a randomized control trial with a larger sample may be necessary to compare the central tendon-splitting combined with the SutureBridge technique with other techniques, our results confirmed that it was a promising alternative for treatment of insertional Achilles tendinopathy.

Achilles Tendon ; surgery ; Calcaneus ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Suture Anchors ; Tendinopathy ; surgery

OBJECTIVETo present a new mini-invasive surgery for compressive optic neuropathy (CON) in Graves' ophthalmopathy (GO) by adequately decompressing the orbital apex and correcting proptosis, and to analyze its results.

METHODSA retrospective chart was reviewed in 29 patients receiving orbital decompression for the treatment of CON secondary to GO from October 2006 to May 2011. All patients diagnosed CON were in stable and inactive phase of GO at least for 6 months. All patients received endoscopic transethmoid medial orbital wall decompression to reduce the compression on the orbital apex. In the meanwhile, an endoscopic transethmoid intraconal fat-removal orbital decompression was performed to remove parts of intraconal fat with a special aspiration/cutting instrument to further reduce the proptosis. All patients were followed up periodically.

RESULTSof improvement of visual acuity (VA), color vision, and amount of proptosis reduction and incidence of induced diplopia 9 months after surgery was recorded for analysis its feasibility.

RESULTSForty-five orbits of 29 patients were included in the study. At the 9 months review, 44 of 45 eyes (97.8%) improved their VA from -0.65±0.30 (x±s) preoperatively to -0.24±0.22, with a mean improvement of 0.55±0.17 (t=-13.012, P<0.001), 23 of 29 eyes (79.3%) had improved color vision (P<0.001), and the mean reduction in proptosis was (7.07±1.59) mm (range 4-11 mm). Postoperative symmetry to within 2 mm were achieved in all patients. Except 1 patient complaining of deterioration in diplopia following surgery, no patients presented new on-set diplopia postoperatively.

CONCLUSIONThe endoscopic transethmoid medial orbital wall decompression combined with the endoscopic transethmoid intraconal fat-removal orbital decompression is an effective treatment with minimal morbidity for both visional recovery and improvement of proptosis for CON in GO.

Adipose Tissue ; surgery ; Adult ; Decompression, Surgical ; methods ; Endoscopy ; Ethmoid Bone ; surgery ; Female ; Graves Ophthalmopathy ; surgery ; Humans ; Male ; Middle Aged ; Orbit ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVEThe purpose of this study is to evaluate the possibility and surgical principle of titanium mesh used for the reconstruction of skull base bone defect.

METHODSThe clinical data of 11 patients with defect of skull base bone repaired with titanium mesh were retrospectively analysed.

RESULTSAmong 11 patients, there were 6 patients with skull base tumor, 3 patients with fibrosis hyperplasia, 2 patients with encephalomeningocele. The surgical approach included craniofacial approach in 7 patients, transfrontal and extended transfrontal approach in 3 patients, trans-midface approach in 1 patient. The anterior and lateral skull base was repaired in 2 patients, anterior and middle skull base and sellar repaired in 6 patients, anterior skull base and orbital floor repaired in 3 patients. In early postoperative period, there were 3 patients with intracranial pneumatosis, but without symptom, and 1 patient with transient cerebrospinal leakage. Following-up for average 14.4 months, there was no titanium mesh displacement and intracranial infection in all patients.

CONCLUSIONSThe titanium mesh used for the repair of skull base bone defect was both possible and safe.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Surgical Mesh ; Titanium ; Young Adult

OBJECTIVETo investigate the association between Chinese patients with autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC) and the polymorphisms of cytotoxic T lymphocyte -associated antigen-4 (CTLA-4) gene promoter (-318) and exon 1 (+49).

METHODSThe CTLA-4 promoter (-318 T/C) and exon 1 (+49A/G) polymorphisms were genotyped via restriction fragment length polymorphism methods in 62 Chinese AIH patients, 77 Chinese PBC patients and 160 healthy controls.

RESULTSThere was no difference in the distribution of CTLA-4 promoter -318 T/C polymorphisms between AIH patients and controls, but the C allele frequency was significantly increased in patients with AIH, compared to controls (P=0.02, OR=2.43). The distribution of CTLA-4 gene exon 1 49 A/G genotypes exhibited significant difference between PBC patients and controls (P=0.006), and the frequency of G allele showed a significant increase in PBC group as compared with controls (P=0.0046, OR=1.8). Although the genotype distribution of the CTLA-4 exon 1-promoter gene displayed no significant difference between AIH and PBC patients and controls, the occurrence of GG-CC was increased in the patients of the two groups (AIH: 32.3%, PBC: 37.7%; control: 22.5%).

CONCLUSIONThe above findings suggest that the polymorphisms of CTLA-4 gene probably confer susceptibility to AIH and PBC in the Chinese population.

Adolescent ; Adult ; Aged ; Antigens, CD ; genetics ; Asian Continental Ancestry Group ; genetics ; CTLA-4 Antigen ; China ; Exons ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Hepatitis, Autoimmune ; ethnology ; genetics ; Humans ; Liver Cirrhosis, Biliary ; ethnology ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; genetics

OBJECTIVETo explore the preventive and treatment effects of smectite powder on enteral bacterial translocation in scalded rats.

METHODSFifty-four Sprague-Dawley (SD) rats were randomly divided into three groups, i.e. normal control (A, n = 6), burn control (B, n = 24), and burn treatment (T, n = 24) groups. The rats in B and T groups were fed with tracing bacteria JM109, which was transfected with PUC19 plasmid in advance. The rats were subjected to 30% TBSA scald injury after the plasmid was shown to have colonized in the intestine. Smectite powder (0.6 g/day/kg) was fed to rats of T group immediately after the scalding, while those in B group received no smectite powder. Bacterial translocation in blood and mesenteric lymph nodes in all groups was observed and identified by enzyme digestion at 12 post scald hour (PSH) and on 1, 3 and 5 post-scald days (PSD). The contents of malondialdehyde (MDA) and superoxide dismutase (SOD) were determined in rat intestinal tissue. And the degree of injury to the entire small intestine was observed pathologically. The villus height of intestinal mucosa was measured, and the rate of epithelial nuclear splitting of mucosal crypts was calculated.

RESULTSThe number of rats with positive blood bacterial culture in B group was obviously higher than that in A and T groups (P < 0.05) on 1 and 5 PSD. The bacterial quantity in mesenteric lymph nodes (MLN) in T group on 1 PSD (38 +/- 16 CFU/g) and 5 PSD (68 +/- 20 CFU/g) were obviously lower than those in B group (228 +/- 67 vs 183 +/- 29 CFU/g, P < 0.05). There was significant difference in the intestinal contents of MDA and SOD between B and T groups at each time point (P < 0.05). The rat jejunum villus height and the epithelial nuclear splitting in the small intestine mucosa in T group were evidently higher than those in B group (P < 0.05 or 0.01).

CONCLUSIONSmectite powder is beneficial to the protection of the intestinal mucosa in scalded rats, and can effectively prevent postburn intestinal bacterial translocation in rats.

Animals ; Bacterial Translocation ; Burns ; drug therapy ; microbiology ; Intestinal Mucosa ; microbiology ; pathology ; Rats ; Rats, Sprague-Dawley ; Silicates ; therapeutic use

OBJECTIVETo study the effect of vitamin B on treatment of hyperhomocysteinemia and endothelial dysfunction in renal-transplant recipients.

METHODSThirty-six stable hyperhomocysteinemic renal-transplant recipients were randomly assigned to vitamin treatment (group A, n = 18, folic acid 5 mg/d, vitamin B(6) 50 mg/d, B(12) 1000 microg/d) or controlled group (group B, n = 18) for 6 months. All subjects underwent assessment of levels for creatinine, creatinine clearance, average pressure, total cholesterol, triglyceride and fasting homocysteine. Endothelial function was evaluated using high-resolution vascular ultrasound.

RESULTSThe levels of homocysteine markedly decreased in group A [(13 +/- 4) micromol/L vs (20 +/- 5) micromol/L, t = 5.3, P < 0.01] after treatment, whereas no significant changes were observed in group B. In group A, endothelium dependent [(12 +/- 5)% vs (9 +/- 5)%, t = 2.9, P < 0.01] and independent [(18 +/- 4)% vs (12 +/- 5)%, t = 3.4, P < 0.01] vasodilatation responses significantly increased after treatment, no significant changes were observed in group B. Endothelium dependent [(9 +/- 6)%, t = 2.8, P < 0.01] and independent [(12 +/- 5)%, t = 3.5, P < 0.01] vasodilatation responses of group A were significantly lower than that of group B after treatment.

CONCLUSIONSVitamin B supplementation can reduce the levels of homocysteine and improve the endothelial function in hyperhomocysteinemic renal-transplant recipients.

Adult ; Drug Therapy, Combination ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Folic Acid ; administration & dosage ; Humans ; Hyperhomocysteinemia ; drug therapy ; physiopathology ; Kidney Transplantation ; Male ; Middle Aged ; Treatment Outcome ; Vitamin B 12 ; administration & dosage ; Vitamin B 6 ; administration & dosage

OBJECTIVE: To compare three assessment methods (TW2, TW2CH, and TW3) for carpal bone age and their potential applications in diagnosis of idiopathic precocious puberty (IPP) in Chinese girls. METHODS: Fifty-five (55) girls with IPP and 83 normal girls as control group were selected in this study. The X-ray films of the left hand-wrist taken at their first visit were analyzed retrospectively. Three assessment methods were used to estimate the carpal bone age with single-blinded method and percentiles were set at 5 different decision thresholds (1)>97th percentile, (2)>90 th percentile, (3)>75th percentile, (4)>50 th percentile, and (5)< or =50th percentile. RESULTS: All of the three methods showed similar high sensitivity and specificity at the threshold above 90th percentile. CONCLUSION Our data indicate that all of the three methods for estimation of the carpal bone age are useful in diagnosis of IPP. TW2CH and TW3 methods appear to be superior to TW2 method.
Age Determination by Skeleton/standards* ; Algorithms ; Bone Development ; Carpal Bones/growth & development* ; Case-Control Studies ; Child ; Child Development ; Child, Preschool ; China ; Female ; Humans ; Puberty, Precocious/diagnosis* ; ROC Curve ; Retrospective Studies

OBJECTIVE: To discuss the diagnostic value of English, Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty (CPP), then to confirm the normal thresholds. METHODS: Sixty one children as patient group were definitely assured CPP. The control group had 67 children. Among them, 61 were normal children, another 6 children as a special control group. Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method. The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0. RESULTS: (1) The skeletal age results showed kappa value is 0.776 deduced by two clinical doctors(u = 16.128, P < 0.05). (2) There were no statistic differences for the areas under ROC curves among three methods. (3) d > or = 1.15 years in TW2, d > or = 1.25 years in TW2-CHN and d > or = 0.65 years in TW2-JP were more susceptive and specific points. CONCLUSION TW2, TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children, and TW2-CHN is highest value for Chinese children.
Age Determination by Skeleton/standards* ; Age Factors ; Body Height ; Bone Development ; Carpal Bones/growth & development* ; Child ; Child, Preschool ; China ; Female ; Hand/growth & development* ; Humans ; Infant ; Male ; Puberty, Precocious/diagnosis* ; ROC Curve ; Sensitivity and Specificity