Objective To investigate the fluid resuscitation strategies to craniocerebral injury patients combined with multiple trauma.Methods This retrospective review was made on 124 patients with combined craniocerebal injury (GCS 3-12 points) plus multiple trauma.Based on the fluid resuscitation strategies,63 patients were treated with aggressive fluid resuscitation (AFR),and 61 with limited fluid resuscitation (LFR).A restrictive rehydration principle was performed with intensive hemodynamic monitoring:mean arterial pressure was kept between 70-80 mmHg for 48 hours and central venous pressure between 6-8 cmH2O for 48 hours in LFR group; mean arterial pressure was kept in basic level and central venous pressure between 8-12 cmH2O in AFR group.No significant differences were shown in the rest of treatments.Parameters were compared between groups such as blood pressure,shock index,coagulation function,imaging data,GCS,and GOS at 6 months postinjury.Results Between-group differences were insignificant with regard to mean arterial pressure (MAP),shock indices,ISS,trauma severity indices (TSI),and GCS (P ＞0.05).Blood pressure fluctuation in LFR group was (18.5 ±9.9) mmHg vs (29.4 ± 11.1) mmHg in AFR group (P ＜ 0.01).Eight patients developed intracranial hemorrhage progression in LFR group,with 3 being treated with craniotomy.In comparison,19 patients developed intracranial hemmorrhage progression in AFR group,with 10 being treated with craniotomy (P ＜ 0.01).Improvement in coagulation disorders was better in LFR group than in AFR group.On days 7 after admission,GCS in LFR groups was (9.1 ± 3.6) points vs (7.2 ± 2.3) points in AFR group (P ＜0.05).At 6-month follow-up,results were 34 good and 27 poor in LFR group,better than 23 good and 40 poor in AFR group.Conclusion For moderate to severe craniocerebral injury combined with multiple trauma,LFR is effective to treat coagulation disorders and hemorrhagic shock,reduce the probability of delayed intracranial hemorrhage,and further improve the outcome.

Objective To explore and conclude the influence factors of long-term outcomes of mitral valve repair for moderate and severe mitral regurgitation due to myxomatous degeneration.Methods To review the in-patient data and followup outcomes of 261 patients after mitral valve repair for moderate and severe mitral regurgitation due to myxomatous degeneration from Jan 1993 to Jan 2008 in Changhai Hospital of Second Military Medical University.Results There were 7 perioperative deaths and 254 survivors who obtained satisfactory perioperative outcomes.During the follow-up,24 patients were lost and 230 patients were followed up from 36 months to 174 months (77.3 ±30.3) months and follow-up rate was 90.6％.Multivariate Cox regression shows age ≥ 60 years old,left ventricular ejection fraction ＜ 0.50,undergoing combined coronary artery bypass grafting were the independent risk factors for long-term death after operations and left ventricular ejection fraction ＜ 0.50,New York Heart Association functional classification Ⅲ-Ⅳ,anterior leaflet prolapse were the independent risk factors for long-term recurrent moderate or severe mitral regurgitation after operations and prosthetic ring or band annulopasty was a protective factor.Conclusion The age ≥60 years old,left ventricular ejection fraction ＜ 0.50,undergoing combined coronary artery bypass grafting,New York Heart Association functional classification Ⅲ - Ⅳ,anterior leaflet prolapse,and prosthetic ring or band annulopasty were closely related with long-term adverse events after operations.

Objective To investigate the effect of plasma fibrinogen (Fib) level on stroke recurrence within one year of first-ever ischemic stroke.Methods The patients with first-ever acute ischemic stroke were enrolled prospectively and were followed up for at least one year.They were divided into either a recurrent group or a non-recurrent group.Multivariate logistic regression analysis was used to explore the risk factors for stroke recurrence within one year of first-ever ischemic stroke.According to the plasma Fib levels of the early onset,the patients were divided into a high Fib group and a normal Fib group.Kaplan-Meier survival analysis was used to compare the recurrence between the two groups.Results A total of 121 patients with first-ever acute ischemic stroke were enrolled,111 completed one year follow up,and 30 of them (27.027％) had recurrent stroke.Multivariatelogistic regression analysis showed that the increased plasma Fib level (odds ratio [OR] 13.238,95％ confidence interval [CI] 1.152-152.077; P=0.038),older at the first onset (OR 1.321,95％ CI1.064-1.641;P=0.012),high body mass index(OR 1.351,95％ CI 1.001-1.823; P=0.049),and poor compliance of antiplatelet drugs (OR 36.819,95％ CI 1.890-717.143; P=0.017) and antihypertensive drugs (OR 50.765,95％ CI 3.198-805.878; P =0.005) were the dependent the risk factors for stroke recurrence within one year of first-ever ischemic stroke.Kaplan-Meier survival function curves showed that the recurrence rate of stroke in the high Fib group was significantly higher than that in the normalFib group (Log-rank test,P =0.000).Conclusions The increased high plasma Fib level,advanced age,obesity,as well as poor compliance of antiplatelet drugs and antihypertensive drugs were the independent risk factors for stroke recurrence within one year of first-ever ischemic stroke.

Aim To investigate the effect of fibrinogenlike protein 1 (FGL1)) silencing on docetaxel sensitivity in human lung adenocarcinoma PC-9 cells. Methods Western blot was used to detect the expression of FGL1 protein in human normal bronchial epithelial cell line BEAS-2B and human lung adenocarcinoma cell line PC-9. The FGL1 gene in PC-9 cell line was silenced by siRNA. CCK-8 assay was used to detect the inhibitory effect of silencing FGL1 on PC-9 cell proliferation and its effect on docetaxel sensitivity. Results Compared with BEAS-2B cell line, FGL1 was highly expressed in PC-9 cell line, and the relative expression of FGL1 protein was 6. 5 times that of BEAS-2B cell line with statistically significant difference (P <0. 01). Silencing FGL1 by transfection with FGLlsiRNA could enhance the inhibitory effect of docetaxel on PC-9 cells. Compared with FGLlsiNC group, the IC50value of PC-9 cells in FGL1siRNA group was significantly reduced with statistically significant difference (P < 0. 01). Conclusions Specific silencing of FGL1 gene could inhibit the expression of FGL1 in human lung adenocarcinoma cell PC-9, inhibit the proliferation of PC-9 cells and increase the sensitivity to docetaxel.

OBJECTIVETo establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

METHODSA Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.

RESULTSClustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).

CONCLUSIONThe establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

Alarmins ; Brain ; Cluster Analysis ; Diarrhea ; classification ; diagnosis ; Hot Temperature ; Humans ; Irritable Bowel Syndrome ; classification ; diagnosis ; Medicine, Chinese Traditional ; Qi ; Retrospective Studies ; Surveys and Questionnaires ; Yang Deficiency

By scattered-sampling testing the disposable sterilized syringe according to legal inspection and explorative research methods of vitro cytotoxicity and easy oxide etc. testing, this article comprehensively evaluated and analyzed the product quality and found the potential risk. The results will help to improve the work process and product quality.
Disposable Equipment ; Product Surveillance, Postmarketing ; Quality Control ; Syringes

Osteoarthritis (Osteoarthritis, OA) is a common clinical degenerative joint disease with increased incidence rate in recent years. Animal experiment is one of the important ways to explore pathogenesis and treatment of OA, while induced animal model is the most important part in animal experiment. Intra-articular injection of drugs is a classical method for establishing animal model of OA. Choose of animal should follows the principle of correlation, appropriateness and practicability, injections should perform in accordance with experimental purposes and subject, detections means and evaluation methods also should corresponding to experimental reality. The gold standard of OA animal model and intra-articular injections has not build, need further study.
Animals ; Cytokines ; analysis ; Disease Models, Animal ; Injections, Intra-Articular ; Mice ; Osteoarthritis ; diagnosis ; etiology ; immunology ; Rabbits ; Rats

OBJECTIVETo study soft tissue changes observed through musculoskeletal ultrasound (MSUS) in the treatment of knee osteoarthritis with needle-knife, so as to provide MSUS basis for needle-knife in the treatment of knee osteoarthritis.

METHODSForty patients with knee osteoarthritis treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from December 2011 to December 2012 were selected according to inclusion and exclusion criteria. All the patients were treated with needle-knife release method. The VAS scores and knee joint circumference were recorded before treatment and 2 weeks after treatment. The changes of knee joint hydrops articuli and joint synovial thickness were measured through MSUS.

RESULTSThe knee pain index was 6.850 +/- 1.417 before treatment and 2.790 +/- 1.299 after treatment;the index after treatment was lower than that of before treatment. The knee joint circumference was 407.320 +/- 45.151 mm before treatment and 391.240 +/- 41.129 mm after treatment; the knee joint circumference decreased after treatment. The amount of hydrops articuli observed by musculoskeletal ultrasound showed that 47 knees were cured, 19 knees improved and 2 knees failed. The synovial membrane thickness: 43 knees cured, 17 knees improved and 8 knees failed.

CONCLUSIONThe hydrops articuli and synovial thickness of knee joint of patients with knee osteoarthritis observed under the MSUS is consistent with the main symptoms and signs, which suggests that MSUS observation on soft tissue changes before and after needle knife in the treatment of knee osteoarthritis with high reliability.

Adult ; Aged ; Female ; Humans ; Knee Joint ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Needles ; Osteoarthritis, Knee ; complications ; diagnostic imaging ; pathology ; surgery ; Pain ; complications ; Synovial Membrane ; pathology ; Treatment Outcome ; Ultrasonography

OBJECTIVETo preliminarily research the formular about the Traditional Chinese Medicine (TCM) syndrome of adolescent neck pain.

METHODSAn observation table of adolescent neck pain syndromes was formulated,and 1 397 patients with adolescent neck pain were investigated to establish a database of adolescent neck pain. The Descriptive Statistical Analysis and Hierarchical Cluster Analysis were performed by statistical software.

RESULTSTotally 60 TCM symptoms was clustered into 4 TCM syndromes by Hierarchical Cluster Analysis. The expert panel of TCM syndromes preliminarily formulate 4 TCM syndromes of adolescent neck pain by analyzing the result of Cluster Analysis and discussing their clinical experience.

CONCLUSIONAdolescent neck pain is a category of Tendon Trauma's Bi-syndrome of TCM. Ying, Wei, Qi and blood block caused by exopathy, strains, and internal injury is considered as the main pathogenesis of adolescent neck pain. Base on statistical result and expert's opinions, 4 TCM syndromes about adolescent neck pain were formulated: cold-dampness syndrome, dampness-heat blockage syndrome, liver-stagnation and spleen-deficiency syndrome, Qi and Yin deficiency of both heart and kidney syndrome.

Adolescent ; Adult ; China ; epidemiology ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Neck Pain ; diagnosis ; epidemiology ; Young Adult

BACKGROUNDLumiracoxib is a highly selective cyclooxygenase-2 (COX-2) inhibitor with antiinflammatory, analgesic and antipyretic activities comparable with class specific drugs, but with much improved gastrointestinal safety. No studies have examined lumiracoxib for antitumorigenic activity on human nonsmall cell lung cancer cell lines in vitro or its possible molecular mechanisms.

METHODSThe antiproliferative effect of lumiracoxib alone or combined with docetaxol on A549 and NCI-H460 lines was assessed by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Drug-drug interactions were analyzed using the coefficient of drug interaction (CDI) to characterize the interactions as synergism, additivity or antagonism. Morphological changes were observed by acridine orange fluorescent staining. Extent of apoptosis was determined by flow cytometry.

RESULTSLumiracoxib (15 - 240 micromol/L) has an inhibitory effect on the proliferation of A549 and NCI-H460 cell lines in concentration- and time-dependent manners with the IC50 values of 2597 micromol/L and 833 micromol/L, respectively. The synergistic effect was prominent when lumiracoxib (15 - 240 micromol/L) was combined with docetaxol (0.2 - 2 micromol/L) (CDI < 1). Fluorescent staining showed that lumiracoxib could induce apoptosis in A549 and NCI-H460 cells. Lumiracoxib treatment also caused an increase of the sub-G1 fraction in each cell line and resulted in an increase of G0/G1-phase cells and a decrease of S-phase cells.

CONCLUSIONSLumiracoxib had antiproliferative effect on the human nonsmall cell lung cancer cell lines A549 and NCI-H460 and had a significant synergy with docetaxol, which may be related to apoptotic induction and cell cycle arrest.

Apoptosis ; drug effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Diclofenac ; analogs & derivatives ; pharmacology ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Taxoids ; pharmacology