Objective Discuss propofol in aged patient do not have painful gastroscope inspection in calm ease pain effect and safety.Methods Inspect gastroseope divide into observation group(propofol group) with compare group(conventional gastroscope group).Observe each group of record to receive the gastroscope operating time.nar- cotic thing role time and reaction in skill,before inspecting in rear BP,HR,SpO_2 and skill rear questionnaire investi- gation.Results The case owned is inspected all consummately,observe group to have negative role less,patient is more easy to accept.Conclusion It is rapid to have effect in propofol inspects without painful gastroscope,recovery time short,negative role lose,is comfortable and safe.

OBJECTIVETo assess effect of acupuncture combined with massage of sole on sleeping quality of the patient with insomnia.

METHODSFifty-eight cases of insomnia were randomly divided into an observation group (n = 32) and a control group (n = 26). The observation group were treated with oral administration of Alprazolam, massage of sole, and acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), etc. on the abdomen as main points; the control group were treated with Alprazolam. Clinical therapeutic effects, and scores for Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were assessed before and after treatment in the two groups.

RESULTSThe effective rate was 93.75 in the observation group and 88.46% in the control group with no significant difference between the two groups; after treatment, there were significant or very significant differences in scores for various factors in the PSQI, SAS and SDS (P < 0.01, P < 0.05).

CONCLUSIONAbdominal acupuncture as main combined with massage of sole can obviously improve sleeping quality of the patient with insomnia.

Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Foot ; Humans ; Male ; Massage ; Medicine, Chinese Traditional ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; therapy

Objective To investigate the auxoaction and mechanism of CDllc+DCs on psoriasis. Methods CDllc+ DCs in the psoriasis-like lesions were confirmed by immunofluorescence double staining experiments. The CD1lc+ DCs were subcutaneously injected into the neck skin of transgenic mice without disease. The clinical features were observed and assessed with PASI score every day. The ear and back skin were checked by HE stained. At the same time, the T lymphocyte and DCs of bone marrow, spleen, submandibular lymph nodes and blood were analyzed by flow cytometry, and the T lymphocyte in the skin lesions were analyzed by immunofluorescence. The heart, liver, spleen, lungs and kindey were HE stained. Results In the psoriasis-like lesions, about 90％ CDllc+ cells expressed CDllc. HE test showed that the thickness of the skin layer was significant different between the experimental group (ear: 29±4 μm; back: 25±3 μm) and the control group(ear: 11±2 μm; back: 9±1 μm) (P＜0.01). CD3 + CD4+ T lymphocyte cells in the blood of the experimental mice (17.87％) were decreased significantly (P＜0.01) compared with the control group mice (31.77％). The numbers of Thl and Th17 cells from bone marrow, spleen, submaxillary lymph nodes and blood, as the same as CD1lc+DCs from bone marrow and submaxillary lymph nodes, were decreased in the experimental mice compared with the control group mice (P＜0.01). The number of CD4﹢T cells, CD8+T cells, IL-17a+cells and IFN-γ+cells in the skin lesions from the experimental group all were higher than that from the control group (P＜0.01). And the vessels in the lesions of the experimental group were higher than that in the control group (P＜0.01). Conclusions CD1 lc+CD1 lc+DCs may play an important role in the occurrence and development of psoriasis by increasing the T lymphocyte and the blood vessel in the skins of K14-VEGF transgenic mice.

Testis specific serine/threonine protein kinase 4 (TSSK4) belongs to the TSSK family, and its members play an important role in spermatogenesis and/or spermiogenesis. Mouse TSSK4 has been reported to be expressed exclusively in the testis and can maintain its kinase activity through autophosphorylation at Thr-197. However, its biological function remains poorly understood. Here we found that GFP-TSSK4-overexpressed HeLa cells showed apoptotic bodies, indicating TSSK4 can lead to apoptosis in vitro. Furthermore, TSSK4 induced apoptosis in different cell lines including HeLa, Cos-7 and H1299 tested by flow cytometry but not its kinase-dead mutant TSSK4-K54M. TSSK4 knockout mice showed increased testes weight and decreased apoptotic spermatogonia and spermatocytes at 21st day after birth tested by TUNEL technology. So TSSK4 was able to induce cell apoptosis in vitro depending on its kinase activity, which leads to abnormal testes weight and apoptosis, shedding light on its function in the process of spermatogenesis and/or spermiogenesis.
Animals ; Apoptosis ; physiology ; Base Sequence ; Cell Line ; DNA Primers ; Flow Cytometry ; Humans ; In Situ Nick-End Labeling ; Male ; Mice ; Polymerase Chain Reaction ; Protein-Serine-Threonine Kinases ; physiology

OBJECTIVETo analyze the reasons of the complications,and the measures taken for the prevention and treatment by percutaneous vertebroplasty (PVP) for osteoporotic thoracolumbars vertebral compressive fractures.

METHODSFrom May 2004 to June 2008, 204 patients with 286 diseased vertebrae underwent PVP under the guidance of C-arm fluoroscopy, and 56 patients with complications included 18 males, 38 females, ranging in age from 58 to 93 years, with an average of 72 years. The condition of leakage of bone cement and complications was observed.

RESULTSThe complications related to the leakage of PMMA found in 60 vertebrae in 49 cases: vertebral canal in 5 cases, intervertebral foramina in 3 cases, soft tissue besides vertebrae in 20 cases,intervertebral discs in 15 cases, venous plexus besides vertebrae in 6 cases. The complications no related to the leakage of PMMA found in 7 cases: the nerve roots injuried in 3 cases; the pain of the patient worsened temporarily in 2 cases; the blood pressure of the patient descent temporarily in 2 cases.

CONCLUSIONThe main reasons of complications are no-integrated of the compressived vertebrae,unstandard skills of injecting,unsuitable opportunity and quantity of injecting PMMA, unsufficient monitoring of C-arm fluoroscopy, the toxicity of PMMA. The measures of prevention and treatment is strict indication, standard skills of injecting, sufficient monitoring of C-arm fluoroscopy, suitable opportunity and quantity of injecting PMMA, electrocardio-monitoring in operation.

Aged ; Aged, 80 and over ; Bone Cements ; adverse effects ; Female ; Fractures, Compression ; complications ; surgery ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Polymethyl Methacrylate ; adverse effects ; Postoperative Complications ; prevention & control ; Spinal Fractures ; complications ; surgery ; Vertebroplasty

Described in the paper is the practice of Chengdu in its pilot of medical alliances in 2015 ,which effectively elevated the medical capacity and quality of care of medical institutions within Pujiang county. Such measures as enhanced management and mechanism ,clarified government responsibility ,standardized medical service quality ,and enhanced coordination within the healthcare system are proposed to enhance the medical alliances and the hierarchical medical system .

OBJECTIVE: To compare the clinical efficacy of pneumatic reduction combined with bone-filled mesh bag implantation and pneumatic reduction combined with kyphoplasty in the treatment of thoracolumbar burst fracture without spinal cord injury. METHODS: The clinical data of 160 patients with thoracolumbar osteoporotic burst fracture without spinal cord injury treated from January 2014 to July 2017 were retrospectively analyzed. There were 66 males and 94 females, aged from 72 to 84 years old with an average of 76.4 years old. The patients were divided into two groups according to different surgical methods, including 80 cases of pneumatic reduction combined with bone-filled mesh bag implantation(treatment group) and 80 cases of pneumatic reduction combined with kyphoplasty(control group). The intraoperative bone cement leakage rate was compared between two groups. The height of the injured vertebrae was measured by X-rays preoperatively and 6-month postoperatively in order to assess height loss of injured vertebrae. VAS score and ODI score were used for follow-up to assess lumbar back pain and autonomic dysfunction before surgery and 2 weeks, 6 months, 1 year after surgery. RESULTS: In treatment group, 3 cases occurred bone cement leakage during operation and leakage rate was 3.75%(3/80); In control group, 14 cases had cement leakage with leakage rate of 17.5%; The difference between two groups was statistically significant(<0.05). All patients were followed up for 13 to 24 months with an average of 14.6 months. Among them, 2 cases occurred postoperative infections which were superficial infections. After oral antibiotics and outpatient treatment infections were controlled. At 6 months after surgery, the height of the injured vertebra was measured by X-ray. Treatment group recovered (5.12±1.31) % and control group recovered (14.11±1.17) %. The difference between two groups was statistically significant (<0.05). At 1 year after surgery, ODI score was 4.03±1.62 in treatment group and 10.03±1.54 in control group. The difference between two groups was statistically significant(<0.05). VAS score was 1.03±0.62 in treatment group and 2.67±0.55 in control group. The difference between groups was statistically significant(<0.05). CONCLUSIONS Extracorporeal pneumatic reduction combined with bone-filled mesh bag implantation technique can significantly reduce the occurrence of intraoperative cement leakage in the treatment of thoracolumbar osteoporotic burst fractures, effectively improve reposition of the injured vertebrae, relieve the pain and recover the function of lower back. However, high price of bone-filled mesh bags obstructs its clinical popularization.
Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae ; Male ; Osteoporotic Fractures ; Retrospective Studies ; Spinal Cord Injuries ; Spinal Fractures ; Surgical Mesh ; Thoracic Vertebrae ; Treatment Outcome

OBJECTIVETo construct the zinc finger protein-activating transcription factor (ZFP-ATF) plasmid and evaluate its efficacy in inducing vascular endothelial growth factor (VEGF) expression in EY.HY926 endothelial cells.

METHODSFirstly, we constructed the ZFP-ATF plasmid, then testified the quantity of VEGF protein in EY.HY926 endothelial cells after transfected with ZFP-ATP plasmid by Western blot, finally, we used the RT-PCR to testify whether the ZFP-ATF can stimulate expression of VEGF splice variants.

RESULTSThe ZFP-ATF DNA sequences were located the multiclone sites of PVAX1 vector between the site of BamH1and Xhol.Western blot result showed VEGF expression in EY.HY926 endothelial cells transfected with ZFP-ATF plasmid was significantly higher than that in cells transfected with VEGF165 (19.95±3.95 vs.12.15±1.55 μg÷μL, P<0.01).RT-PCR result showed VEGF-A mRNA expression level induced by ZFP-ATF was high than that induced by VEGF165.

CONCLUSIONZFP-ATF can up-regulate the VEGF-A expression in comparison with VEGF165, which might have beneficial effects in angiogenesis process.

Activating Transcription Factors ; physiology ; Amino Acid Sequence ; Base Sequence ; Cells, Cultured ; Endothelial Cells ; metabolism ; Humans ; Molecular Sequence Data ; Neovascularization, Physiologic ; Plasmids ; Up-Regulation ; Vascular Endothelial Growth Factor A ; genetics ; Zinc Fingers ; physiology

OBJECTIVETo study diagnosis and therapeutic efficacy of transient oeteoporods of the hip (TOH).

METHODSFrom January 2005 to February 2010, 5 patients with TOH were treated with traditional methods. All the patients were male, with an average age of 38.6 years (ranged, 27 to 46 years). The clinical manifestation, physical examination and imageology characteristic was investigated. The therapeutic efficacy was evaluated by Harris hip score.

RESULTSAll the patients were followed up, the duration ranged from 12 to 36 months (averaged, 24 months). The Harris hip score before treatment were 63.1, 86.0, 74.9, 63.6 and 64.8 respectively, while after 6 months treatment, the scores improved to 90.5, 94.5, 89.7, 93.9 and 87.8 respectively. Moreover, 6 months later, the abnormal signal disappeared in MR imaging and X-ray.

CONCLUSIONTransient osteoporosis of the hip is a self-resolving condition and a self-limited disease, the expectant treatment is useful for it.

Adult ; Female ; Hip Joint ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoporosis ; diagnosis ; therapy ; Retrospective Studies

OBJECTIVETo summarize the experiences and shortcomings of repair of wounds on hands due to electrical burns with flaps, aiming at further improvement.

METHODSClinical data of 425 patients with electrical burn of hands admitted to Burn Institute of Wuhan, City Hospital NO. 3 & Tongren Hospital of Wuhan University from January 2000 to December 2006 were collected and summarized. Therapeutic methods and outcomes of all patients were statistically analyzed. Flap types, complications after surgery and problems existed in patients having undergone flap transplantation were summarized. Patients were divided into surgery within 7days post burn (PBD) group (SW) and surgery after PBD 7 group (SA) according to the timing of surgery. Survival rate of flaps and incidence of complications in patients of two groups were compared.

RESULTSOut of the 425 patients, 348 (90.2%) patients underwent surgery, among which 248 flaps of different types were transplanted in 209 patients, including 202 (81.5%) distant pedicle flaps, 19 (7.7%) local flaps, 12 (4.8%) free flaps, and 15 (6.0%) other kinds of tissue flaps. Five flaps failed because of necrosis of torn off, and the resulting wounds were treated with other methods. Eight flaps showed necrosis of distal margin, and the wound healed with dressing changing or skin grafting. All the remaining flaps survived with satisfactory cosmetic and functional results. In SW group (n = 170) and SA group (n = 78), survival rate of flaps was respectively 98.8% (168/170) and 96.2% (75/78), incidence of complications was respectively 10.6% (18/170) and 12.8% (10/78). There was no statistical difference between above two sets of data (with chi(2) value respectively 0.81 and 0.27, and P values both above 0.05).

CONCLUSIONSThere are many types of flaps that can be used to repair electric burn wounds on hands. Appropriate choice and design of flaps, skillful operation, and careful post-operation observation and treatment are key points for good therapeutic effect.

Adolescent ; Adult ; Burns, Electric ; surgery ; Child ; Female ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult