Objective To study the therapeutic effect of diltiazem and felodipine in treatment of hypertension after renal transplantation.Methods Sixty patients with hypertension after renal transplantation who were treated with tacrolimus as basic immunosuppressive therapy were divided into two groups by random digits table method with 30 cases each.The diltiazem group took diltiazem 90 mg orally once a day.The felodipine group received felodipine 2.5 mg orally twice a day.The drug dosages were adjusted according to the level of blood pressure.The patients were followed up for 1 year.The artery pressure,concentration-to-dose ratio of tacrolimus and renal function was detected and compared.Results Blood pressure was significantly decreased in both groups after 1 year treatment.Blood pressure was found to be significantly lowered from (153.6± 7.5)/ (97.7 ±6.7) mm Hg (1 mm Hg=0.133 kPa) to (119.1 ± 26.4)/ (72.6± 19.3) mm Hgin felodipine group; and from (152.0 ± 7.6)/(95.4 ± 6.9) mm Hg to (120.3 ± 25.5)/(73.2 ± 22.5) mm Hg in diltiazem group.There was no significant difference in blood pressure before and after treatment between two groups (P ＞ 0.05).The concentration-to-dose ratio of tacrolimus was increased after treatment in diltiazem group[(173.2 ± 59.3) g/L vs.(119.3 ± 78.3) g/L] (P ＜ 0.05),but there was no significant difference before and after treatment in felodipine group (P ＞ 0.05).The serum creatinine had no significant difference in two groups (P ＞ 0.05).Conclusion Diltiazem and felodipine can be used safely and effectively in the treatment of hypertension after renal transplantation,and diltiazem can lower the dose of tacrolimus.

Objective To summarize our experience in managing cerebrospinal fluid(CSF) rhinorrhea. Methods 82 cases of cerebrospinal fluid rhinorrhea treated in our department from 1995 to 1999 were reviewed retrospectively. 61 were male and 21 were female.They ranged from 2 to 82 years old.CSF leak was caused by trauma in 43 cases,iatrogenic injury in 18 cases and spontaneous leak occurred in 21 cases. Results 36 cases underwent surgical repair.The closure rate was 86 11%.Otorhinolaryngologists underwent 25 cases,and 23 cases succeeded (92%).The department of neurology underwent 11 cases,and 8 cases succeeded (72 7%). Conclusions The repair of CSF leak through transnasal extracranial approach can obtain better therapeutic results,especially through intranasal endoscopy.

[Objective]To review the treating effect of cases of the developmental dysplasia of the hip in old age children by a one-stage combined Pemberton operation and femoral shortening and investgate if the hip joint stiffness rate and ischemic necrosis rate of femoral head after operation are reduced. [Method]From June 2002 to Decempber 2006, 136 hip congenital dislocation of 101 old age children (7 years to 14 years) were treated by Pemberton operation and femoral shortening,and were followed-up from 1.5 years to 4 years(average, 2 years and 7 months).[Result]Thirty-one cases can only bend their hip joint below 90 degrees, accounting for 22.79% of all. Thirty-eight ischemic necrosis of femoral head occurred which accounted for 27.94%.The rate of ischemic necrosis of the femoral head and hip joint stiffness of old age children after operation were reduced obviously according to the standard by Salter.[Conclusion]Pemberton operation and femoral shortening are preferred in treating the developmental dysplasia of the hip of old age children.It can reduce the rate of ischemic necrosis of femoral head and hip joint stiffness.

The authors reviewed the research and development of tissue engineered meniscus from three points (cell seeds, scaffolds, cell factors) and point out current questions and investigative direction in the future.

Objective To explore the secondary inventory appropriate to improve the stomatological hospital in cost control for medical consumables,standardizing patient charging,dynamic materials management,zero inventory and enhancing hospital economic benefit.Methods An enterprise resource planning (ERP) secondary inventory information system was developed to solve the problems in medical materials management of the stomatological hospital,and then went through practical trials in three departments to determine its efficacy and deficiencies.Results The information system facilitated cost control,standardized patient charging,and the trials in three departments showed the rate for material consumption was decreased greatly.The deficiencies still existed in the traceability,mobile App,manual input and etc.Conclusion The ERP secondary inventory information system reduces the running cost of the department,increases the hospital abilities in cost control and management,and thus is worthy promoting practically.

10.3969/j.issn.1000-8179.2013.12.012

Based on entire literature retrieval about low back pain treated with acupuncture and moxibustion, Clinical Practice Guideline for Low Back Pain Treated with Acupuncture and Moxibustion was drafted according to method of evidence quality and recommended intensity grading system(GRADE). This article specificly introduces the aim and available diseases of the guideline. The principle and recommended plans are also detailedly explained.
Acupuncture Therapy ; methods ; standards ; China ; Humans ; Low Back Pain ; therapy ; Moxibustion ; methods ; standards ; Practice Guidelines as Topic

ObjectiveTo investigate the characteristic of pathology in Chinese patients with Nonaka myopathy.MethodsThirteen patients (7 males and 6 females) diagnosed with Nonaka myopathy in our laboratory from January 2002 to March 2011 were included in this study.Their mean age was 39.5 years old and the mean duration of illness was 4.15 years.The most common symptoms were weakness of raising feet with sparing of quadriceps femoris muscles in the early stage of disease.One patient presented the initial symptoms of upper limb weakness. Muscles biopsies were obtained from all these 13 patients. Histology study including immunohistochemical (IHC) staining with antibody against amyloid 3,phosphorylated tau protein,ubiquitin,glucose-regulated protein of molecular weight 78 000(GRP78),calnexin,caspase-12and Bax were performed.Skeletal muscle samples from 3 chronic fatigue syndrome patients,2 myofibrillar myopathy patients were used for control in the IHC staining. All coding exons of uridinediphospho-N-acetylglucosamine 2-epimerase gene were directly sequenced in genomic DNA from these patients.Results The main pathological changes of tibialis anterior muscle in 12 cases were muscle dystrophy with rimmed vacuoles.The rimmed vacuoles were positive for anti-β-amyloid,tau protein and ubiquitin in IHC studies.In the atrophy fibers,IHC showed the increased expression of endoplasmic reticulum stress related proteins GRP78 and calnexin,and apoptosis proteins of caspase-12 and Bax.ConclusionsThere is accumulation of abnormal proteins in muscle fibers in Chinese patients with Nonaka myopahty.These proteins may stimulate endoplasmic reticulum stress and apoptosis,which may be a mechanism responsible for muscle damage.

Objective To report the spectrum of electron transfer flavoprotein dehydrogenase (ETFDH)gene mutations in 20 Chinese RR-LsM families.Methods Twenty-four RR-LSM patients in the First Hospital of Peking University from January 2003 to May 2010 were collected and the clinical characteristics were analyzed.These patients came from 20 families in North Mainland China.Sixteen families had 1 patient each.and the other 4 families had 2 patients.ETFDH gene analysis was performed in all patients,11 family members and 100 healthy controls.Results The mean onset age was(27.9±9.9)years.The main symptoms were limb weakness(21,87.5%),dysmasesia(15,62.5%),neck weakness (14,58.3%)and myalgia(14,58.3%).Eighteen patients had high level of acyleamitine.Fifteen of 17patients had glutaric aciduria.Seventeen ETFDH mutations,including 13 missense mutations,2 splice mutations,and 2 nonsense mutations,were identified in 19 families:c.998A>G,c.1450T>C,c.1703T>C,c.1717C>T,c.821G>A,c.643G>A,c.251C>T,c.1763A>T,c.IVS7+2T>C and c.IVS6+1G>A were Hovel mutations which were not found in 100 healthy controls.Nine families had the mutation of c.770A>G(P.Y257C)and 5 families had the mutation of c.1227A>C(P.L409F).Conclusions The numerous novel mutations in ETFDH gene indicate that Chinese RR-LSM might have special mutation pattern.c.770A>G(P.Y257C)and c.1227A>C(p.L409F)may be hot spot mutations in North Mainland China.

Objective To compare the image quality and scanning dose of time-subtraction and dual-energy-subtraction cerebral CT angiography, and to assess clinical application value of both methods. Methods Plain and enhanced scanning were performed on 60 patients suspected cerebral vessel diseases with dual-source CT. Dual-energy mode with tube voltages of 140 and 80 kV was used in enhanced scanning, and data of two different energy were collected in one scanning. ①Traditional removed-bone digital subtraction (time-subtraction) with plain and 80 kV enhanced scanning data were obtained. Volume render (VR) and maximum intensity projection (MIP) reconstruction were finished; ②Direct removed-bone digital subtraction (dual-energy subtraction) with 80 kV and 140 kV enhanced scanning data were obtained. VR and MIP reconstruction were finished. The image quality of VR and MIP was divided into 4 grades, and were compared as well as average effective radiological dose. All the diseases were confirmed with surgery or DSA. Average effective radiological dose was compared with time-subtraction and dual-energy subtraction. Results Internal carotid artery trunk and branch and Willis circles were displayed clearly with two methods in 60 cases. No significant difference was found (P>0.05) between total quality score of the two methods. The size, shape, neck and axis point of aneurysm in 24 cases were clearly displayed, so as the shape and extent of abnormal vessel bolus in 4 cases, while arteries and veins were also clear in artery-vein malformation; ③The average radiological dose was (26.60±0.50)mSv in time-subtraction and (22.40±0.50) mSv in dual-energy subtraction. Conclusion The normal, abnormal vessels and diseases can be clearly displayed at time-subtraction and dual-energy subtraction CTA. The effect of dual-energy-subtraction is better than that of time-subtraction CTA in no-cooperation patients, and the radiological dose is lower in dual-energy CTA.