ObjectiveTo investigate the clinical effect and treatment experience of complicated acetabular fractures treated with open reduction with combined ilio-inguinal and Kocher-Langenbeck (K-L) approaches.MethodsSixty-six patients with complicated acetabular fractures were treated surgically with combined ilio-inguinal and K-L approaches from February 2004 to December 2009.Among them,45 cases were followed up for 8-45 months,with the average 26 months.ResultsOperation time was 1.4-5.7 h,with the average of 2.8 h.Intraoperative blood loss was 530-2300 ml,with the average of 1250 ml.According to Matta's score system,the excellent and good rate was 86.7％.According to modified Merle d' Aubigne and Postel score system,the excellent and good rate of function of hip was 86.7％.According to Brooker heterotopic ossification standard assessment system:Ⅰ degrees in 6,Ⅱ degrees in 3.According to Letournel and Judet clinical classification system,postoperative traumatic arthritis were 6 patients.Among them,3 patients with Ⅲ- Ⅴ period with symptoms of serious hip pain and joint activities obstacles were treated with total hip replacement secondly.Six cases of sciatic nerve injury and 9 cases of lateral femoral cutaneous nerve damage were recovered gradually after six months to a year.All incisions healed primarily.All got bony union,the healing time was 8 to 16 weeks,with the average of 10.4 weeks.None was complicated with femoral head necrosis.ConclusionFor the patients with complicated acetabular fractures,open reduction with combined ilio-inguinal and K-L approaches can get clinical advantages of revealed fully,fracture restoration convenient,fixed tightly,fewer complications and satisfactory result.

In order to increase the SNR of the prostate image, we have designed a RF endorectal coil. Its properties have been evaluated using a network analyzer. Moreover the images got with a special phantom show that the coil has much higher SNR at the region of interest (ROI).
Algorithms ; Equipment Design ; Humans ; Image Enhancement ; instrumentation ; methods ; Magnetic Resonance Imaging ; instrumentation ; methods ; Male ; Phantoms, Imaging ; Prostate ; anatomy & histology ; Sensitivity and Specificity

OBJECTIVE: To compare the anesthesia properities of hyperbaric bupivacaine with those of isobaric and hypobaric solutions when administered in the supine position undergoing hip surgery or lower limb surgery using continuous spinal anesthesia. METHODS: Sixty patients( ASA I approximately III ) scheduled for hip or lower limb surgery were randomly divided into 3 groups with 20 patients in each group: Group A: 0. 375% hyperbaric bupivacaine solutions; Group B :0.375% isobaric bupivacaine solutions; and Group C: 0. 375% hypobaric bupivacaine solutions. The following variables were measured every 2 minutes during the first 30 minutes after the intrathecal injection : the onset time of sensation block, the highest plane of analgesia, the time to reach complete motor blockade, and the plane of analgesia and the extent of lower extremities' movement (modified bromage score, BMS) at different time after the administration. Meanwhile the changes of hemodynamics were recorded. RESULTS: There was no statistical difference among the basic conditions ( P > 0.05). The onset time of sensation block, and the time to reach complete motor blockade, and the time receiving the highest sharp pain sensory block in Group A were significantly shorter than those in Group B and Group C ( P < 0.01 ). The plane of analgesia obtained in the hyperbaric group was significantly higher than in both the isobaric and the hypobaric groups ( P < 0.01). The mean arterial pressure(MAP) , HR in the hyperbaric group decreased significantly after the intrathecal injection( P < 0.05 ). CONCLUSION The 0.375% Isobaric bupivacaine used during contiuous spinal anesthesia in the supine position produces a suitable and a more "controllable" anesthesia, but a minimum dosage of 10 approximately 12.5 mg is required to obtain adequate anesthesic conditions with moderate hemodynamic changes and satisfying analgesia effects. Under similar conditions, 0. 375% hyperbaric bupivacaine produces major hemodynamic consequences with high cephalad spread and 0. 375% hypobaric bupivacaine has a too long onset time.
Adult ; Anesthesia, Spinal ; methods ; Bupivacaine ; Female ; Hemodynamics ; Hip Joint ; surgery ; Humans ; Injections, Spinal ; Lower Extremity ; surgery ; Male ; Middle Aged ; Posture ; Solutions

OBJECTIVETo observe the efficacy and safety of PEG-interferon alpha-2a (PEG-IFNalpha-2a) treatment on lamivudine (LAM)-resistant chronic hepatitis B (CHB) patients.

METHODSEighty-one patients with lamivudine-resistant HBeAg (+) chronic hepatitis B patients were enrolled and divided into PEG-IFNalpha-2a treatment group (40 cases) and adefovir dipivoxil (ADV) control group (41 cases). Two groups were combined with LAM in the first 12 weeks(w). The ALT normalization rate, the HBV DNA and HBeAg negative rate, and the HBeAg seroconversion rate were observed in 12 W, 24 W, 48 W.

RESULTSThe ALT normalization rate in 12 W, 24 W of PEG-IFNalpha-2a group was 62.5% and 80.0%. And it was higher than that of ADV group. The HBeAg negative rate and HBeAg seroconversion rate in 48 W of PEG-IFNalpha-2a group were 60% and 57.5% , which were higher than that of ADV group. The difference was statistically significant (P < 0.05).

CONCLUSIONPEG-IFNalpha-2a treatment of lamivudine-resistant HBeAg (+) chronic hepatitis B is superior to ADV, and its security is well.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; analysis ; drug effects ; Drug Resistance, Viral ; drug effects ; genetics ; Female ; Hepatitis B virus ; drug effects ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Interferons ; immunology ; pharmacology ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Mutation ; Organophosphonates ; therapeutic use ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; Treatment Outcome ; Watchful Waiting

OBJECTIVETo identify the original plant of "Daibaijie", commonly used Dai herb.

METHODThe literature review, morphology and anatomy, pharmacognosy, molecular biology, chemistry were used to analysis.

RESULTDaibaijie's historical scientific name, Dregea sinensis Hemsl., was mistakenly given "Daibaijie" and D. sinensis have significant differences from the distribution, morphology and anatomy, pharmacognosy, molecular biology and chemical composition. "Daibaijie" matches with the characteristics of Marsdenia tenacissima (Roxb.) Moon in Flora of China in English.

CONCLUSIONDaibaijie's original plant is M. tenacissima (Roxb.) Moon. The description and illustration of M. tenacissima (Roxb.) Moon in Flora of China in China are wrong. The illustration of M. tenacissima in Flora of China in English is wrong too.

China ; ethnology ; Herbal Medicine ; Marsdenia ; anatomy & histology ; classification ; Medicine, Chinese Traditional ; Plant Components, Aerial ; anatomy & histology ; classification

OBJECTIVETo study the alkaloids of Macleaya cordata and their anti-tumor activities.

METHODAlcohol and liquid-liquid extraction were used methods were used to extract the alkaloids constituents, and silica gel, reverse-phase octadecylsilyl (ODS), sephadex LH-20 chromatographic methods and HPLC were applied to isolate and purify compounds. MS, NMR spectroscopic methods were used to determine their structures. Furthermore, the cytotoxicity of these chemical components for MCF-7 and SF-268 cell lines was measured by MTT method.

RESULTTwelve alkaloids were isolated from the fruits of M. cordata, and their structures were identified as: maclekarpine E (1), 6-acetonyldihyrochelerythrine (2), cavidilinine (3), 6-acetonyldihyrosanguinnarine (4), O-methylzanthoxyline (5), 6-methoxy-dihydrosanguinarine (6), spallidamine (7), 6-hydroxyldihydrochelerythrine (8), arnotianamida (9), dihydrosanguinarine (10), protopine (11), and cryptopine (12).

CONCLUSIONCompounds 1, 3, 7-9 were isolated from M. cordata for the first time, and compound 5 is a new natural product. The results of cytotoxic assay indicated that compound 6 showed strong cytotoxicity against MCF-7 and SF-268 cell lines with IC50 values of 0.61 μmol · L(-1) and 0.54 μmol · L(-1), respectively.

Alkaloids ; isolation & purification ; pharmacology ; Antineoplastic Agents, Phytogenic ; isolation & purification ; Cell Line, Tumor ; Humans ; Papaveraceae ; chemistry

Objective: To observe the clinical efficacy of mind-refreshing and balance-restoring needling method combined with Frenkel exercises in treating ataxia after cerebral stroke. Methods: The recruited 120 patients were randomized into an observation group and a control group, with 60 cases in each group. The control group was intervened by mind-refreshing and balance-restoring needling method, while the observation group was given additional lower-limb Frenkel exercises. Before and after treatment and at the follow-up, the ataxic lower-limb function was scored using Berg balance scale (BBS) and international cooperative ataxia rating scale (ICARS), and Barthel index (BI) was adopted to score the activities of daily living (ADL). Results: After treatment, the markedly effective rate was 70.2％ and the total effective rate was 96.5％ in the observation group, versus 39.7％ and 87.9％ in the control group, and the differences in the markedly effective rate and the total effective rate were statistically significant (P<0.01, P<0.05). The intra-group comparisons showed that the BBS, ICARS and BI scores after treatment and at the follow-up were significantly different from those before treatment in both groups (all P<0.01).There were significant differences in the BBS score between the two groups after treatment and at the follow-up (P<0.05, P<0.01); the between-group differences in the ICARS and BI scores were statistically insignificant after treatment (both P>0.05), while the between-group differences in the ICARS and BI scores were statistically significant at the follow-up (both P<0.05). The interaction effects between the scoring time of BBS and BI and the group factor were statistically significant (P<0.01, P<0.05). Conclusion: Mind-refreshing and balance-restoring needling can effectively improve the lower-limb ataxic symptoms and ADL after stroke; when combined with Fenkel exercises, this needling method can produce more significant efficacy.

Objective To evaluate the effects of ganglioside GM1 on hypoxic ischemic brain damage (HIBD) in neonatal rats and on the expression of potassium-chloride cotransporter 2 (KCC2) in hippocampus.Methods Seven-day-old Sprague-Dawley (SD) rats (n=72) were randomly divided into a sham group,an HIBD group and a ganglioside GM1 group.Each group was further divided into a 3 d subgroup and a 21 d subgroup according to the different detection index (n=12).Rat HIBD models were prepared according the Rice-Vannucci method.After HIBD,the ganglioside GM1 group was given ganglioside GM1 20 mg/ (kg ·d) by intraperitoneal injection for 3 d continuously.2-,3-,5-triphenyltetrazolium chloride (TTC) was preformed to evaluate the area of cerebral infarction of HIBD in each 3 d subgroup.Spontaneous activity recorder was used to observe the locomotor activity of the rats in the 21 d subgroups.Morris water maze test was conducted for assessment of rats' learning and memory abilities in the 21 d subgroups.Western blot analysis was employed to determine the alterations in KCC2 expression in hippocampus in all the 3 d and 21 d subgroups.Results Compared with the HIBD group (28.6％±5.2％),the ratio of cerebral infarction volume in the ganglioside GM1 group (11.3％±2.4％) was significantly reduced (P＜0.05).Compared with the HIBD group (289.6±61.3),the number of locomotor activities within 2 h in the ganglioside GM1 group (412.1±66.8) was significantly increased (P＜0.05).Compared with the HIBD group,the escape latency was significantly reduced,but the percentage time of target quadrant and the number of crossing the platform were significantly increased in the ganglioside GM1 group (P＜0.05).Three days and 21 days after HIBD,the expression of KCC2 in the ganglioside GM1 group was significantly higher than that in the HIBD group (P＜0.05).Conclusion Ganglioside GM1 may have a significant protective effect on HIBD in neonatal rats,and its mechanism may be related to regulation of the expression of KCC2 in hippocampus.

BACKGROUND AND OBJECTIVEMonitoring the therapeutic effects of radiotherapy for nasopharyngeal carcinoma (NPC) is critical to providing individualized treatment. This in-vivo study was initially designed to evaluate the therapeutic effect of radiotherapy using 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET-CT) imaging.

METHODS18F-FDG PET-CT imaging was performed on all of the 10 nude mice bearing NPC xenografts before radiotherapy, and early-phase and delayed-phase PET-CT images were performed on 7 of the 10 mice. All mice were randomly divided into either a control group or a radiotherapy group. The 5 mice in the control group were immediately killed after the imaging and pathology were performed. After receiving radiotherapy of 12 Gy, 5 animals in the radiotherapy group were given 18F-FDG PET-CT imaging on days 2, 4, and 6, and then were killed for pathologic evaluation. Regions of interest (ROI) technology was used to measure the tumor target/non-target (T/NT) ratio and the volume of the tumors.

RESULTSThe average T/NT ratios of early- and delayed-phase imaging were 1.806 +/- 0.532 and 1.777 +/- 0.597, respectively, with no significance (P > 0.05). For the radiotherapy group, the average T/NT ratios for 18F-FDG PET-CT before radiotherapy, and on days 2, 4, and 6 after radiotherapy, were 1.735 +/- 0.466, 1.818 +/- 0.396, 1.096 +/- 0.101, and 0.604 +/- 0.108, respectively, The tumor volumes were (1.48 +/- 0.27) cm3, (1.57 +/- 0.31) cm3, (1.59 +/- 0.31) cm3 and (1.60 +/- 0.29) cm3, respectively. The average T/NT ratios of day 6 after radiotherapy and the other time points were significant (P < 0.05). The average death ratio of the tumor cells was (93.00 +/- 7.42)% after 6 days of post-radiotherapy.

CONCLUSIONS18F-FDG PET-CT imaging can be used for the early assessment of radiotherapeutic effect of NPC in vivo. Day 6 after radiotherapy may be an appropriate time point for the imaging. However, the T/NT ratio measurement of delayed-phase imaging might make no sense for the diagnosis of NPC.

Animals ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; radiotherapy ; Cell Line, Tumor ; Fluorodeoxyglucose F18 ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Multimodal Imaging ; methods ; Nasopharyngeal Neoplasms ; diagnostic imaging ; pathology ; radiotherapy ; Neoplasm Transplantation ; Positron-Emission Tomography ; Random Allocation ; Tomography, X-Ray Computed ; Tumor Burden ; radiation effects

AIM:To investigate the distribution and mechanism of M 1/M2 macrophages in inflammatory injury and repair process of renal tissues .METHODS: SD male rats ( n=45 ) were randomly divided into 2 parts: ischemia-reperfusion injury (IRI) and unilateral ureteral obstruction (UUO) renal injury.The rats with IRI were divided into sham operation group and operation groups (0, 6, 24, and 72 h after operation), and the rats with UUO were divided into sham operation group and operation groups (3, 7 and 14 d after operation).Automatic biochemical analyzer was used to detect serum levels of creatinine and urea nitrogen .The degree of renal injury in IRI group and UUO group were detected by HE staining.The expression of CD68 was examined by immunohistochemical staining .The levels of inducible nitric oxide syn-thase (iNOS), arginase-1 (Arg-1), transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α(TNF-α) were measured by ELISA.The polarizations of M1 ( CD68 +, F4/80 + and CD16/32 +) and M2 ( CD68 +, F4/80 +and CD206 +) macrophages were analyzed by flow cytometry .RESULTS:In IRI group, the infiltration of CD68 +macrophages and the degree of injury were increased with the prolongation of time in the renal tissues .At 24 h, the tissue injury and macrophage infiltration were the most serious , but then decreased .At 72 h, the tissue damage and CD68 +macrophage in-filtration were significantly reduced .In UUO group, obstructive injury was increased with the prolongation of time , and at 14 d, marked fibrous hyperplasia occurred .The infiltration of CD68 +macrophages at 7 d was the most serious , but then reduced at 14 d.Flow cytometry analysis showed that M 1 macrophages were the majority in the early stages of UUO and IRI, and the result of ELISA identified the higher level of iNOS .At the late stage of injury , the M1 macrophages were de-creased, while the M2 macrophages were increased with higher level of Arg-1.M1 macrophage-mediated early injury was due to the induction of TNF-αexpression, and M2 macrophage-mediated later recovery was due to enhancing TGF-β1 levels.CONCLUSION:The polarization of M1 and M2 macrophages is involved in the processes of UUO and IRI .M1 macrophages play a key role in early injury , and M2 macrophages contribute to the late stage of fibrotic repair .The polari-zation of macrophages during renal injury and repair provides a guiding significance for the clinical treatment .