ObjectiveTo observe the 2-8 years' follow-up results of percutaneous laser disc decompression(PLDD) on cervical spondylotic radiculopathy,and to identify factors affecting the outcome of PLDD.MethodsEighty-seven patients with cervical spondylotic radiculopathy were treated consecutively by PLDD in our hospital from December 2002 to June 2009,who were followed up for 2-8 years.There were 32males and 26 females,with the mean age of 51.8 years (range,26-74).The results were evaluated according to the Japanese Orthopedic Association's score of cervical spondylotic radiculopathy(JOA 20 score) and numeric rating scales (NRS) after surgery.Two years after the operation,the excellent and good rate of JOA score of patients with different genders,ages and duration of each subgroup will be compared.ResultsThe excellent and good rate were 37.9％,51.7％,65.5％,81.0％,82.8％,80.9％,72.4％ and 72.7％ at 1,3,6months and 1,2,4,6,8 years after operation respectively.Significant difference was found between the time points of 6 months to eight years after operation and that of one month after operation.The NRS score of the pain symptoms at the final follow-up was significantly reduced(P＜0.05).The excellent and good rate of patients whose course of disease (93.3％) was less than 18 months was significantly higher than that of those whose course of disease was over than 18 months(71.4％) two years after operation (P＜0.05).Conclusion The intermediate-term curative effect of PLDD for the treatment of cervical spondylotic radiculopathy is reliable and stable,and the postoperative curative effect may be influenced by patients' duration of disease.

Objective This study aimed to explore the clinical characteristics and treatment of congenital central hypoventilation syndrome(CCHS),to raise awareness on the CCHS for early diagnosis and treatment.Methods The clinical data of 4 babies with CCHS were analyzed,all of the babies were repeated bruising,hypercapnia,and difficult-to-wean.After the relevant checks,we precluded the primary diseases of heart,lung and neuromuscular dysfunction that lead to low ventilation,and detected the major pathogenic genes,Phox2b of CCHS,refer to literature and diagnostic criteria of CCHS.Results Four babies all had typical clinical features of CCHS:enough ventilation when awake.But when they were asleep,their respiratory rate slowed down,hypoventilation,cyanosis and hypercapnia appeared,and they can not be awaked by hypercapnia and hypoxemia caused by hypoventilation.Genetic testing confirmed the presence of Phox2b mutations.Two infants were supported by non-invasive biphasic positive airway pressure(BiPAP),an infant was discharged home at 3 months of age with non-invasive BiPAP,and an infant was discharged home at 1 month of age.Both of them were monitored and treated at home,and showed normal development.Conclusion For babies who were repeated bruising,hypercapnia,and difficult-to-wean,but no primary diseases of heart,lung and neuromuscular dysfunction that lead to low ventilation,CCHS must be considered.Genetic testing of Phox2b can be used as an important diagnostic tool,and non-invasive BiPAP is one of the efficacious methods in the treatment of CCHS.

This study was aimed to explore the factors impacting on effect of the recombinant human granulocyte colony-stimulating factor (rhG-CSF) in mobilizing and collecting peripheral blood stem/progenitor cells (PBSPC) from healthy donors, and to determine the optimal time for PBSPC harvest. A mobilization course in 431 healthy donors was retrospectively studied and the factors influencing the efficacy of mobilization were analyzed. The normal donors underwent leukapheresis for PBSPC collection in multicentres after mobilization with G-CSF administered. A variety of items analyzed included donor age, sex, weight, body mass index (BMI), daily G-CSF dose and schedule of G-CSF administration. The results showed that G-CSF was administered subcutaneously at median 5.7 microg/kg for mobilization for 3 - 5 days, The median number of peripheral blood mononuclear cells (PBMNC) count of per kg recipient weight was 9.57 x 10(8) and CD34(+) cells per kg recipient weight was 4.91 x 10(6) after a median of 1.7 leukapheresis. The side effects were mild and well tolerated. By univariate analysis, BMI, daily G-CSF dose and schedule of administration were significantly correlated with the yield of PBMNCs, CD34(+) cells. The best apheresis yields of PBMNCs and CD34(+) cells were achieved on day 5 after treatment with rhG-CSF. Because the narrow range and low dose of rhG-CSF administration, there were minor effects of rhG-CSF dose compared with schedule of administration. It is concluded that mobilization and leukapheresis are safe in healthy donors and that the low dose of rhG-CSF in 5-day administration are probably optimal for donor management.
Adult ; Female ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; Hematopoietic Stem Cell Mobilization ; Humans ; Leukapheresis ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; methods ; Recombinant Proteins ; Tissue Donors ; Young Adult

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.
Acetophenones ; chemistry ; Animals ; Anisoles ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Gas Chromatography-Mass Spectrometry ; Oils, Volatile ; chemistry ; Rats ; Tannins ; chemistry

BACKGROUND:Traditionally, forced expiratory volume in one second (FEV1) was used to evaluate exercise response of patients with asthma; however, patients obviously had panting after exercise, so FEV1 was affected commonly. Impulse oscillometry (IOS) is a new technique for measuring respiratory impedance that do not require maximal inspiration and forced expiration.OBJECTIVE: To study airway resistance with IOS before and after exercise in healthy and asthmatic patients and investigate the significance of exercise excitation and IOS assessment.DESIGN: Synchronically non-randomized case contrast study.SETTING: Department of Respiratory Medicine, East Hospital Affiliated to Tongji University.PARTICIPANTS: A total of 14 male patients with bronchial asthma who were regarded as the asthmatic group were selected from Department of Respiratory Medicine of Shanghai East Hospital from January to October 2006. They were in a clinical stationary phase. Another 14 male healthy subjects were selected as the control group and ages of all subjects ranged from 29 to 50 years. All subjects provided the confirmed consent.METHODS: IOS was used to measure basic value of respiratory resistance, and then subjects underwent exercise challenge. Nose of subjects was clipped breathing through mouth. Within 3-4 minutes, heart rate was increased to 90% and maintained for 6 minutes during challenge. Respiratory resistance was repeatedly measured at 1, 5, 10, 15 and 20 minutes after exercise, including airway hyperresponse (AHR), total respiratory resistance, central resistance, peripheral resistance and resonance frequency at 5, 20 and 35 Hz of pulse frequency, elasrtic resistance and inertia resistance (X5 and X35) at 5 and 10 Hz of pulse frequency. In addition, difference of AHR at 5 and 35 Hz was calculated, and change ratios of both Rcentral and Rperipheral were calculated as (highest value after exercise-baseline value)/baseline value × 100%.MAIN OUTCOME MEASURES: Basic value of respiratory resistance by using IOS and exercise challenge test.RESULTS: All 14 patients with bronchial asthma and 14 healthy subjects were involved in the final analysis. Peripheral resistance (Rperiphera) was significantly higher than central resistance (Rcentral) in asthmatic patients (P ＜ 0.01). The maximal increase of respiratory impedance occurred from 5 minutes to 10 minutes after exercise in asthmatics. Resonance frequency (Fres) of asthmatics before and after exercise was significantly increased than that of controls (P ＜ 0.01).Change ratios of Fres from asthmatics were higher than that from control group (P ＜ 0.01). After challenge, R5, R5-R20,Zrespir and X5 from asthmatics changed significantly than that from controls (P ＜ 0.01). The increment change value of After exercise Zrespir increased significantly, because obstruction of small bronchi during expiration and impedance increased abruptly. Air trapping was expressed in VT-Zrespir graph in 57.1% patients. There was no difference in the VT-Zrespir graph of controls before and after exercise.CONCLUSION: The main site of airflow obstruction was in small airways in asthmatics after exercise challenge. The general acceptance of IOS method was good among the asthmatic patients. The airway response of exercise challenge may be assessed more accurately with IOS that do not require a maximal inspiration and forced expiration.

Through an introduction to the importance of medical ethics education and the status quo, this paper discusses how to better combine the medical ethics education with medical students′medical practices. It puts for-ward some suggestions from the institutional arrangements, personnel allocation, and publicitymethods. The ulti-mate goal is that the medical students could get more effective, continue and integration medical ethics education in the process of medical practice.

Cirrhosis with portal hypertension is a common disease which has a significant impact on the quality of patients' life. Esophagogastric devascularization (EGDV) has been demonstrated to be an effective method to treat portal hypertension, however certain complications are associated with it. The purpose of this study was to evaluate the effectiveness and clinical outcome of the selective EGDV (sEGDV) for the treatment of portal hypertension. The study was conducted prospectively from Jan. 1 2011 to Dec. 31, 2012, and 180 patients were randomized to the sEGDV group (n=90) or the non-sEGDV (n-sEGDV) group (n=90). Patients' demographics, preoperative lab test results and operative details were comparable between the two groups. Postoperative and short-term complications were analyzed in two groups. There was statistically significant difference (P<0.01) in the PVF reduction between the two groups. Post-operative complications showed no statistically significant difference between the two groups in the incidence of bleeding, ascites, acute portal vein thrombosis, fever and hepatic encephalopathy. Mortality between two groups was comparable. The incidence of splenic fossa effusion after the surgery was lower in sEGDV group than in n-sEGDV group. There were no significant differences in the short-term follow-up data such as esophageal varices and portal hypertensive gastropathy (P>0.05). It is suggested that sEGDV is a safe, simple and effective surgical procedure. It has both the advantages of the shunt and devascularization because it preserves body's voluntary diversion. With the advantage of low incidence of postoperative complications, it is an ideal surgical approach for the treatment of portal hypertension.

OBJECTIVE:To study antibacterial activities of meropenem(MPN)combined with cefoperazone sulbactam(SCF) to 3 kinds of multidrug resistance (MDR) Gram-negative bacteria. METHODS:Each 50 strains of MDR-Escherichia coli (MDR-EC),MDR-Klebsiella pneumoniae (MDR-KPN) and MDR-Acinetobacter baumannii (MDR-AB) were isolated from spu-tum,blood,urine,ascites or drainage specimens of patients during Jan. to Dec. in 2016 from the affilidated hospital of Taishan medical university. The agar dilution method and board method were used to determine MIC50,MIC90 and MICG of MPN,SCF, MPN+SCF to MDR-EC,MDR-KPN,MDR-AB and calculate fractional inhibitory concentration (FIC). Drug sensitivity test was conducted by K-B disk method. RESULTS:In terms of the MICG to MDR-EC,MDR-KPN,MDR-AB,MPN alone were respec-tively 36.82,82.45,34.32 μg/mL;SCF alone were respectively 42.14,112.67,24.11 μg/mL;MPN combined with SCF were re-spectively 25.97,56.64,11.36 μg/mL. In terms of MICG to MDR-EC,MDR-KPN,MICG showed that MPN+SCF0-0.5 (78.00%),>0-0.5(72.00%),>0.5-1.0 (82.00%). CONCLUSIONS:MPN combined with SCF can effectively improve antibacterial activities to MDR Gram-negative bac-teria as MDR-EC,MDR-KPN,MDR-AB. MPN combined with SCF has synergistic effects.

Objective To investigate the clinical value of miRNA-34a,miRNA-34c,and miRNA-135a in the early diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD).Methods The patients were collected in the outpatient and inpatient of Neurology during Aug 2014 to May 2016.The levels of miRNA-34a,miRNA-34c,an dmiRNA-135a were detected with quantitative real-time polymerase chain reaction (qRT-PCR).Results AD patients had higher level of miRNA-34a than the controls.The levels of miRNA-34c were higher in MCI and AD patients,while lower levels of miRNA-135a compared to the controls.Conclusions The miRNA 34a and miRNA-135a were likely to became the biomarker in early diagnosis of MCI and AD.

OBJECTIVE To evaluate the difference of efficacy of sublingual immunotherapy on different age patients with allergic rhinitis. METHODS 229 patients with dermatophagoides farina drops allergic rhinitis who have finished SLIT at least 2 years were enrolled and analyzed by retrospective analysis. All patients were divided into different age groups: pre-adolescence(n=107), adolescence(n=53), adulthood(n=69). Indexes for therapeutic effects of SLIT visual analogue scale(VAS) score, rhinitis symptom scores, medication scoreintra- and inter groups were assessed during different stage of treatment(3 months, 1 year and 2 years). Data were analyzed with SPSS 19.0 software. RESULTS Compared with prior treatment, after the SLIT for 3 months, 1 year, 2 years, VAS scores, rhinitis symptom scores, medication scoresof all the patients with allergic rhinitis are significantly decreased; Differences of rhinitis symptom scores(H=0.844, 4.153, 2.669, P>0.05), VAS score(H=1.356, 3.720, 0.313, P >0.05), medication scores(H=1.044, 5.841, 3.399, P>0.05) between groups had no statistical significance at different stage after treatment(3 months, 1 year and 2 years); The differences between 2 years and 1 year of SLIT treatment showed statistical significance in the VAS scores(Z=1.635, P =1.635). CONCLUSION SLIT with dust mites drops had good curative effect and security in patients with allergic rhinitis, which hadno obvious difference between different age groups.