Anxiety Disorders ; etiology ; therapy ; Breast Neoplasms ; complications ; therapy ; Humans ; Medicine, Chinese Traditional ; Qi

Chromatography, Gas ; methods ; Chromatography, High Pressure Liquid ; methods ; Humans ; Hypnotics and Sedatives ; blood ; Pentobarbital ; blood ; Pharmaceutical Preparations ; blood ; Sensitivity and Specificity

Lumbar intervertebral disc herniation clinical symptoms and signs are very complicated, lumbocrural pain is the most characteristic clinical symptoms,and show the site (range or area), intensity, nature, evolution, influence factors and adjoint symptoms and so on has certain characteristics and rules. Among them, the dermatomal pain, kinesthetic dysesthesia, dynamic changing pain and lesions segment vertebral side deep tenderness are the most impotent characteristics and rules of pain, therefore, can be regarded as the main basis of clinical diagnosis of the disease, and also the core content of this article.
Back Pain ; diagnosis ; etiology ; pathology ; Humans ; Intervertebral Disc Displacement ; diagnosis ; pathology ; Lumbar Vertebrae ; injuries ; pathology

OBJECTIVETo explore the therapeutic efficacy of unilateral multiple channels approach in percutaneous vertebroplasty (PVP) for osteoporotic vertebral fractures.

METHODSA retrospective review (from March 2003 to October 2012) was conducted on 685 consecutive patients, a total of 885 vertebrae were involved. Eighty-two cases (99 vertebrae) with bone cement leakage when less than 0.3 ml bone cement was injected to fill the fracture were given PVP procedure by unilateral multiple channels approach. 38 cases were male (45 vertebrae) and 44 cases were female (54 vertebrae). The average age was 75.4 years old (from 69 to 92). The operation time, amount of injected bone cement and complications were recorded. Rate of excellent and good outcomes was studied by measuring the cement distribution on the X-ray film. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function respectively at preoperation and 1 hour, 1 month, 3 months and 6 months after operation.

RESULTSAll these ninety-nine vertebrae were treated in 82 cases with PVP of unilateral multiple channels approach. The average operation time was 33 minutes. The rate of excellent and good outcomes of cement distribution was 98.8%. The VAS score was (8.40 +/- 0.73) before surgery,and (2.50 +/- 0.43), (2.00 +/- 0.33), (1.80 +/- 0.28), (2.10 +/- 0.17) at 1 hour, 1 month,3 months and 6 months respectively after operation. ODI was (40.94 +/- 2.72) before surgery, (9.64 +/- 2.60) at 1 month after surgery, (8.52 +/- 2.30) at 3 months after surgery and (7.77 +/- 2.15) at the final follow-up. The differences of the VAS and ODI between pre-operation and post-operation had statistical significance (P<0.01). No spine or nerve injuries occurred intraoperatively.

CONCLUSIONThe unilateral multiple channels approach in percutaneous vertebroplasty can obviously relieve the pain and effectively improve the functional activity, provide a satisfied cement distribution in vertebral body with cement leakage after a small amount infusion.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Osteoporosis ; surgery ; Retrospective Studies ; Spinal Fractures ; surgery ; Treatment Outcome ; Vertebroplasty

Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Glioma ; pathology ; Humans ; Sesquiterpenes ; administration & dosage ; pharmacology ; Time Factors

Background Proliferative vitreoretinopathy (PVR) is one of the major causes of retinal detachment surgery failure.Based on proteomic studies of PVR vitreous,the insulin-like growth factor binding protein-6 (IGFBP-6) protein was specifically expressed in the vitreous and serum of PVR patients.Furthermore,its expression level is higher in the vitreous and serum in severe PVR patients than that in mild PVR patients.Objective This experiment was to detect the expression of IGFBP-6 in a PVR rat model.Methods Seventy 7-week old male SPF Wistar rats were included and were randomized into the PVR model group and control group.A mixture of RPE-J cell suspension(5 μl) and platelet-rich plasma (5 μl) was intravitreally injected in the left eyes of adult Wistar rats to establish the PVR model,and normal saline solution was administered in the same way in the control group.The rat eyes were clinically examined 1 week,2,3 and 4 weeks after injection,and PVR was graded based on the criteria of Francine.The animals were sacrificed after 1 week,2,4 or 8 weeks for the preparation of retinal sections and liver extraction.Expression levels of IGFBP-6 mRNA in the rat retina and liver were assayed by real-time Q-PCR.The expression of IGFBP-6 protein in the rat serum and vitreous was detected by ELISA.The use of animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Purified IGFBP-6 RNA was extracted from the liver and retina of Wistar rat and quantified by real-time Q-PCR.The expression level of IGFBP-6 mRNA in retina was (3.79± 1.33) × 10-4 in the PVR model rats,showing a significant decline in comparison with the control rats with a level of(8.32±2.96) × 10 4,4 weeks after injection (t =3.42,P＜0.01).The expression of IGFBP-6 mRNA in the 4th week was significantly lower than that of 1 week,2 or 8 weeks after the establishment of the PVR model(P＜0.05).No significant difference was found in the IGFBP-6 mRNA level in the liver between the PVR group and control group(27.60± 14.01 × 10 4 vs.25.01 ± 12.04 ×10-4,respectively),as well as among the different time points(P＞0.05).IGFBP-6 mRNA content in the retina was significantly reduced in grades 1,2 or 3 of the PVR groups compared with the control group(P＞0.05),but there was no significant difference among the different grades of PVR groups (P＞0.05).Concentrations of IGFBP-6 protein in grades 1,2 and 3 of the PVR model group were (221.00 ± 19.32),(229.63 ± 18.89) and (225.70 ± 26.71) μg/L,with a significant elevation in comparison with (173.25 ±21.11) μg/L of the control group (t =2.14,P＜0.05).However,there was no significant change among the different grades of PVR groups(t=1.24,1.46,P＞0.05).The concentrations of IGFBP-6 protein in the vitreous and serum were higher in PVR rat samples (vitreous:225.44±19.36 μg/L;serum:108.48 ± 15.78 μg/L) than in control rats (vitreous:173.25 ± 21.11 μg/L,serum:95.96 ±17.40 μg/L)(P＜0.05).Conclusions The concentrations of IGFBP-6 protein in the vitreous and serum increase in PVR rats.The results indicate that the increased IGFBP-6 in the vitreous might be a localized autocrine secretion of the eye.

Objective To explore the protective effect of L-carnitine on neonates with myocardial injury caused by as?phyxia. Methods Forty-four neonates with myocardial injury caused by asphyxia were randomly divided into L-carnitine treatment group (21 cases) and control group (23 cases). Patients in control group were received routine treatment and pa?tients in treatment group were given L-carnitine 0. 1 g/(kg · d) on the basis of routine treatment for 7 days. Symptoms and physical signs were observed before therapy and during the treatment in two groups. Before and after the treatment, plasma levels of free L-carnitine and cardiac troponin I (cTnI) were detected with the method of colorimetric assay and chemilumi?nescent, respectively. Results The clinical effective rate was significantly higher in treatment group than that of control group (90.48%vs 60.87%, P<0. 05). Compared with the control group, there was a significantly higher plasma concentra?tion of free L-carnitine in treatment group after treatment [(27.00±5.69)μmol/L vs (13.20±3.04)μmol/L, P<0.05]. In treat?ment group, plasma concentration of free L-carnitine was significantly higher after treatment than that of pre-therapy [(14.87 ± 3.95)μmol/L,P<0.05]. Compared with the control group, there was a significantly lower plasma concentration of cTnI after treatment in treatment group [(0.025±0.006)μg/L vs (0.046±0.010)μg/L, P<0.05]. In the treatment group, there was a significant correlation between decreased plasma concentration of cTnI and increased plasma concentration of free L-carnitine (r=0.899, P<0.05). Conclusion Administration of L-carnitine can effectively decrease the abnormal plasma lev?el of cTnI in neonates with myocardial injury caused by asphyxia, and thereby protect the myocardium.

Objective To evaluate the efficacy and safety of the improved percutaneous balloon mitral valvuloplasty (PBMV) in elderly patients with mitral stenosis. Methods Elderly patients with severe mitral stenosis received an improved PBMV which included a modified way of atrial septal puncture and technique across the mitral valve. The left atrial pressrue (LAP), mean pulmonary pressure (MPA), mean gradient across the mitral value (MPG) and mitral valve area (MVA) were recorded and compared before and after the operation. Long term follow up were made. Results After operation, the LAP decreased [(25.3±6.7) mm Hg vs.(16.4±5.8) mm Hg,1 mm Hg=0.133 Kpa], MPG decreased [(17.6±6.7) mm Hg vs.(6.8±2.9) mm Hg], MPA decreased [(38.6±12.1) mm Hg vs. (29.2±9.8) mm Hg], MVA increased [(1.05±0.22)cm2 vs.(1.61±0.38)cm2] and the New York heart association heart function classification improved. The follow-up result showed that the effect of PBMV was constant. Conclusions Improved PBMV may be an effective and safe measure for patients with mitral stenosis.

Pain is all lumbocrural pain cases very common clinical symptoms,but the etiology, pathology, site (range or area), intensity, nature, evolution situation and influence factors of pain usually has some certain characteristics and rules, these differences particularly are regarded as the primary and important basis or clue for the clinical diagnosis and differential diagnosis of related diseases. In addition, according to these differences can determine the individual diagnosis of lumbar intervertebral disc herniation as well, including typical and atypical, simple and compound, the general and special cases, these be- come the basis to determine the individualized therapeutic schedule of this disese.
Back Pain ; diagnosis ; Humans ; Intervertebral Disc Displacement ; diagnosis

Pain is common clinical symptoms of lumbocrural, but the etiology, pathology, sites (range or area), intensity, nature, evolution situation and influence factors of pain has some certain characteristics and rules. These differences particularly were regarded as the primary and important basis or clues for the clinical diagnosis and differential diagnosis of related diseases. A series of exclusive diagnosis for similar symptoms is premise of diagnosis of lumbar intervertebral disc protrusion. Ideas and methods of differential diagnosis of lumbar intervertebral disc herniation can help the diagnosis and identification.
Diagnosis, Differential ; Humans ; Intervertebral Disc Displacement ; diagnosis ; Lumbar Vertebrae