[Objective]To discuss the surgical treatment of huge tumor invovled sacrum.[Method]A review of records in 18 patients with tumors invovled sacrum was made.Age at surgery averaged 43 years(range:31~65),eleven patients were male,seven patients were female.In this series,malignant tumor was in 14 cases,according to Enneking classification,these cases were classified toⅠA~ⅠB subtypies,which concluded chordoma(8 cases),giant cell tumor(5 cases)and osteochondroma(1 case).Benign tumor was in 4 cases with neurogenic tumor(3 cases)and aneurysmal bone cyst(1 cases).[Result]Over all,no patients were dead in the operation,no other major complications were occurred,the blood loss during surgery was 1 000 ml to 5 000 ml.All incisional wound were primary healing except 4 cases,two of them gained secondary closure after gluteus maximus pushing flap.Eighteen patients gained follow-up visiting,the average time of follow-up was 30 months,only 2 cases were tumor recurrence.[Conclusion]Huge tumors invovled sacrum present a great challenge,because of many organs surrounding sacrum invovled and complexity in anatomic region,sacrectomy of sacral tumor always complic generous blood loss,disorder of urination and defecation,disorder of sexual function et al.Abdominosacral approach can lead to a safer and relative radical local control of tumor,it is benefit to protect blood vessel and nerves.

Objective To explore whether respiratory tract viruses infection was involved in the pathogenesis of steroid sensitive and simple nephrotic syndrome(SSSNS).Methods Expression of respiratory tract viruses gene and antigen in peripheral blood mononuclear cells(PBMC) and production of viruses antibody in sera from 26 children with steroid-sensitive and simple nephrotic syndrome were evaluated by reverse transcription polymerase chain reaction(RT-PCR),APAAP and ELISA.Results In compared in active phase with remission group of SSSNS and normal age-matched controls,the positive rate of viruses of active phase group was significantly increased(P

Adolescent ; Humans ; Male ; Pigmentation Disorders ; pathology ; Skin ; pathology

ObjectiveTo review the surgical technique and outcome of intracranial angiographically occult vascular malformations (AOVM) hemorrhage. Methods40 patients with spontaneous intracranial hemorrhage episodes and accepted microsurgery were analyzed retrospectively. ResultsAll AOVMs were successfully resected. No operative death occurred.36 patients were followed up for mean 28 months. CT and/or MRI revealed no residual lesions. Most neurological complications improved postoperatively. 1 case demonstrated rebleeding in surgical site 48 months after operation. Another case, a follow-up MRI scan revealed a contralateral denovo lesion 44 months after operation.ConclusionA current neurosurgical procedure is a satisfactory method to prevents AOVMs rebleeding. Long-term follow-up evaluation is necessary despite the lesion has been totally resected.

Objective To investigate the effect of the whole course health education on heart rehabilitation of old patients with percutaneous coronary intervention(PCI).Methods One hundred and twentyone old patients with coronary heart disease who all underwent complete PCI in Tangshan Gongren Hospital from January 2008 to December 2009 were selected as our subjects.All subjects were randomly divided into the intervention group (60 cases) and the control group (61 cases).All patients were treated by PCI ± standard drug therapy.Patients in control group were given the conventional health education,while in intervention group were given the extending health education plus the conventional health education.Questionnaire was used to collect the coronary heart disease knowledge,recovery and secondary prevention behavior.The levels of blood pressure,density lipoprotein cholesterol,fasting blood glucose (FB) were measured at 6,12,24 months at discharge hospital.Meanwhile the reaching standard rate of coronary heart disease risk factors control was also used to evaluate the effect of education.Results The scores of knowledge of coronary heart disease rehabilitation of intervention group at 6,12 and 24 months after discharge were (79.69 ± 4.66),(83.26± 8.38),(81.81 ± 9.21) respectively,higher than that of control group ((72.36 ± 8.16),(69.96 ± 10.69),(70.00 ± 11.32) respectively),and there were significant differences between groups(t =3.26,5.39 and 4.41respectively,P ＜ 0.05).The scores of the second level prevention act of intervention group were (79.00±5.65),(79.88 ± 6.34) and (79.13 ± 11.21) respectively,higher than that of control group((70.72± 7.59),(68.84 ± 5.36) and (66.52 ± 9.15) respectively),and there was significant difference between groups (t =3.75,5.99 and 3.63 respectively; P ＜ 0.05).The reach standard rate of low density lipoprotein cholesterol(LDL-C),exercise of intervention group at 6 months were 60.0％ (36/60),65.0％ (39/60),higher than that of the control group(37.7％ (23/61),32.8％ (20.61)),and there was significant difference between groups(x2 =6.045,10.871,P ＜0.05),while there was no significant difference in terms of the reach standard rate of blood pressure,FB and quit smoking(P ＞ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were 75.0％ (45/60),76.6％ (46/60),96.6％(58/60),81.7 ％ (49/60),75.0％ (45/60),higher than that of control group (49.2 ％ (30/61),32.8 ％(20/61),80.3％ (49/61),57.4％ (35/61),31.1％ (19/61),and there was significant difference between groups(x2 =8.021,28.438,8.431,10.435 and 23.128 respectively,P ＜ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were (75.0％ (45/60),81.7％ (49/60),95.0％ (57/60),86.7％ (52/60),81.7％ (49/60)),higher than that of control group (44.3％ (27/61),31.1％ (19/61),75.4％ (46/61),47.5％ (29/61),34.4％ (21/61)),and there was significant difference between groups (x2 =11.710,35.810,8.112,25.450 and 25.650 respectively,P＜0.05).Conclusion Whole course health education is proved to reach the purpose of long-term heart rehabilitation,and decrease the risk of the risk factors for PCI.Meanwhile it is a safe,effective,compliant heart rehabilitation model after PCI in old patients.

Objective: Fetal monitoring is extremely important in perinatal care. Analysis of cardiotocogragh(CTG) can suppose if the fetus is lack of oxygen, distressed, acidosis, etc. in order to take measures timely. Methods: We have designed Meticare analysis software package to analyze 867 pieces of CTG data, and researched the relationship between short term variation (STV) and basal heart rate(BHR) by statistics, and short time monitoring analysis based on STV. Results: The amplitude of fetal heart rate curve variation(long term variation) tended to decrease when BHR increasing, with the negative correlation and regression equation STV = 9.866-0.02×BHR. Positive correlation exists between 5 and 10 mimute-STV, with the regression equation STV_(10min)=2.861-0.596×STV_(5min).Conclusion: STV calculated by 5 minutes CTG data can forecast the one by 10 minutes data as a reference demanded by Dawes & Redman criterion. If fetal doppler contains STV analysis function, out-patient fetal heart auscultation will be more significant. After 30 weeks pregnancy, with the STV decreasing, fetal distress, asphyxia, low birth weight, and even mortality increasing. BHR increasing should cause attention that STV might decrease, when monitoring with no analysis functional devices or fetal dopplars.

BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; prevention & control ; Phytotherapy

Background The characters of diabetic retinopathy (DR) include capillary occlusion,microcirculation disturbance and retina neovascularization near ischemic areas of the retina.The pathogenic mechanism is still incompletely clear,but the primary mechanism of DR is the change of permeability of retinal blood capillary.Objective The aim of this study was to investigate the effect of lycium bararum polysaccharides (LBP) on the blood glucose,blood fat and permeability of blood-retinal barrier in diabetic rats.Methods Fifty-four clean adult SD rats were randomized into 4 groups.The diabetes mellitus models were created in 36 SD rats by injection of 45 mg/kg streptozotocin(STZ) via caudal vein.The rats with the blood glucose ＞ 16.7 mol/L were defined as the diabetic mellitus in 72 hours after injection.LBP of 200 rmg/( kg · d) was intragastriccally administered in 18 models once a day in LBP group,and equal volume of normal sodium was used at the same way in 18 models in DM group,and 18 normal rats were as normal control group.The rats were killed in 4,8 and 12 weeks respectively for the detect of blood glucose level,triglyceride,total cholesterol.The retina tissue were isolated for the quantification of vascular permeability using Evans blue method.Results The blood glucose level was significantly elevated in the DM group and LBP group compared with normal control group,and that in LBP group was obviously declined in comparison with the DM group with a 57％,40％,36％ fall off in 4,8,12 weeks respectively,showing a statistically significant differences( P＜0.05 ).The triglyceride concentration was considerably raised in the DM group compared with normal control group in all of the time points( P＜0.01 ),however,the rise of triglyceride concentration was found only in 12 weeks in LBP group(P＜0.05).The cholesterol level was increased in 8 and 12 weeks in DM group compared with normal control group and that of LBP group went up only in 12 weeks (P＜0.0l ).The Evans blue contents in dry retina tissue were(26.23±2.00),(29.78± 1.78 ) and( 34.08±3.03 ) μg/g in 4,8,12 weeks in the DM group,and those of LBP were ( 13.27 ±0.77 ),( 18.01 ± 1.77 ),( 25.05 ±:1.50 ) μg/g,showing statistical differences between two groups ( P＜0.01 ).However,in comparison with normal control group ( 12.34 ±4.30,12.76 ± 2.11,12.45 ±4.40 μg/g),the Even blue content were elevated in various time points (P＜0.01 ).Conclusions LBP can suppress the increase of the blood-retinal barrier permeability in STZ-induced diabetic rat by lowing the levels of blood glucose,triglyceride and total cholesterol.These results suggest that LBP has a therapeutical effect on DR.

Background5-Nitro-2-(3-styrene-acrylic amine) benzoic acid ( NPPB),a chloride channel inhibitor,has a promoting effect on cell apoptosis in myocardial ischemia and reperfusion of domestic rabbit.The CIC chloride channel has been found in the ocular trabecular cells.However,the effect of NPPB on the shape and function of trabecular cells is unclear. Objective This study was performed to investigate the effect of NPPB on the proliferation,cell cycle progression and apoptosis of human trabecular meshwork cells.MethodsThe immortalized human trabcular cell strain was cultured,and logarithmic-phase cells were incubated in 96-well plates at a density of 1 ×106/ml.Different concentrations of NPPB (10,50,100 μ mol/L) were added to the medium,and the MTT assay was used to assess the growth and proliferation of the cells.Flow cytometry was used to evaluate the cell cycle.Then,100 mg/L 5-FU or 100 mg/L 5-FU + 100 μmol/L NPPB was used to induce cell apoptosis,which was assessed by Annexin V-PI.The membrane potential of mitochondria was examined using rhodamine 123 (△ψm).Results After 48 hours of treatment with NPPB,the abosorbency (A value) of the cells was gradually lowered with the increasing dose of NPPB,with significant differences among the 4 groups (F =7.230,P =0.006).Compared with the 10 μmol/L NPPB group,the A values were significantly declined in the 50 and 100 μmol/L NPPB groups (t =1.610,P =0.025 ;t =12.270,P =0.001 ).Forty-eight hours after exposure to NPPB,the percentage of cells in G0/G1 phase was increased and that in the S phase was decreased.The percentages of cells in different phases of cell cycle were significantly different in comparison with their control groups (without NPPB)( P＜0.05 ).Twenty-four and 48 hours after the treatment with 100 mg/L 5-FU,the apoptosis rates of the cells were raised in the 100 mg/L 5-FU group and 100 mg/L 5-FU + 100 μmol/L NPPB group compared to the without NPPB group (t24h =2.130,P =0.023;t48h =4.810,P=0.011 ) ;while that in the 100 mg/L 5-FU+100 μmol/L NPPB group was higher than the 100 mg/L 5-FU group ( t24 h =1.980,P =0.037 ; t48 h =1.290,P =0.028 ),and the mitochondrial membrane potential was lowered ( t24h =1.580,P =0.029 ; F48 h =6.200,P =0.015 ).Conclusions NPPB suppresses the proliferation of human trabecular cells and promotes the cells to enter S phase via the G1/S check point.In addition,ClC might be involved in an anti-apoptosis mechanism through the internal mitochondrial pathway.