Objective To study the methods and results of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms. Methods Twenty-one patients with PICA aneurysms were treated with endovascular treatment. The locations of aneurysm on PICA were evaluated through the DSA. Eight patients received single coil embolization, 5 received liquid Glue embolization, 2 received coil embolization combined with liquid Glue, 2 received coil embolization assisted with stents, and 4 underwent ocelasion of the parent PICA. Outcome was evaluated with the Glasgow outcome scale (COS). Results There were complete (100%) occlusion in 5 patients, near complete (>90% ) occlusion in 2, and incomplete (85%) occlusion in 1 in single coil embolization. Seven patients with Glue embolization (n = 5 ) or combination with coils ( n = 2 ) exhibited complete ( 100% ) occlusion. There were near complete ( >90% ) occlusion in 2 cases with coil assisted with stents. Complete occlusion of the parent PICA was achieved in 3 patients, and near complete occlusion of PICA in one case. One patient suffered from new neurological deficits, and one patient treated with coils and stents died. None of the patients suffered from re-bleeding. These patients received follow-up during a mean period of (22±8) months. Overall long-term outcome was good ( GOS score 4 or 5 ) in 17 patients, poor ( COS score 2 or 3) in 3, and fatal ( GOS score 1 ) in one case. Conclusions According to the location of aneurysms on PICA, aneurysms can be effectively and safely treated with endovaecular embolization.

Objective Renal ischemia-reperfusion may cause myocardial injury and dexmedetomidine ( DEX)is a new alpha-2 adrenergic agonist which has the effects of antisympathia , sedation and analgesia.The article was to observe the effects of different doses of dexmedetomidine on myocardial injury induced by renal ischemia -reperfusion(I/R) in Rats. Methods 40 male Wistar rats were randomized into 5 groups(n=8 each)using a random number table: sham operation group(isolation of bilateral renal pedicles without ligation), I/R group (3 hours′reperfusion 120 minutes after the right nephrectomy and the ligation of left renal artery ), DEX low dose group, DEX middle dose group and DEX high dose group (DEX 25, 50, 100 μg/kg were respectively injected intraperitone-ally in rats of the three groups plus 3 hours′reperfusion after 120 minutes′ischemia ) .Blood samples were collected at 3 hours′reper-fusion to determine serum creatinine(Cr) and blood urea nitrogen(BUN) concentrations.Kidney and myocardial specimens were ex-tracted for microscopic examination and IL-10,TNF-αcontent were detected by ELISA. Results In sham operation group, renal structure was normal.In I/R group, a great amount of erythrocyte infiltration and interstitial infiltrating inflammatory cells were found in glomerulus and a lot of exfoliative cells were found in renal tubules .In DEX low dose group , erythrocyte infiltration and interstitial infiltrating inflammatory cells were found in glomerulus and a few exfoliative cells were found in renal tubules .In DEX middle dose group, erythrocyte infiltration and interstitial infiltrating inflammatory cells were found in partial glomerulus and a few exfoliative cells were found in renal tubules .In DEX high dose group , erythrocyte infiltration and interstitial infiltrating inflammatory cells in partial glomerulus were found and rare exfoliative cells were found in renal tubules .In sham operation group , cardiomyocytes were arranged in perfect order and normal structure , and chromatins and cytoplasms were in uniform distribution .In I/R group, edema and spongiform were obvious in cardiomyocytes , and focal coagulative necrosis was observed along with a great amount of infiltrating inflammatory cells and rare flaky bleeding .In DEX low dose group , edema and spongiform were found in cardiomyocytes , and focal coagulative necrosis was observed along with a great amount of infiltrating inflammatory cells and rare flaky bleeding .In DEX middle dose group , edema was found in cardiomyocytes , and mini focal coagulative necrosis was observed along with a small amount of infiltrating inflammatory cells.In DEX high dose group , edema was found in cardiomyocytes along with a small amount of infiltrating inflammatory cells .Com-pared with sham operation group , Cr, BUN concentrations in serum and IL-10,TNF-αcontents in kidney tissue and myocardium signif-icantly increased in I/R group, low dose group, middle dose group and high dose group(P<0.05).Compared with I/R group, IL-10 contents kidney tissue and myocardium significantly increased in small dose group (P<0.05).Cr ([167.11 ±18.81, 135.46 ± 9.80, 114.29 ±12.50, 100.15 ±8.81]μmol/L), BUN ([13.42 ±1.25, 11.73 ±1.15, 10.27 ±0.78, 9.28 ±0.52] mmol/L) concentrations in serum and TNF-αcontents in kidney tissue ([578.45 ±30.59, 530.76 ±20.59, 482.23 ±27.12, 423.14 ± 21.16]ng/L) and myocardium ([565.00 ±37.66, 517.82 ±36.89, 469.99 ±32.43, 407.41 ±23.77] ng/L) significantly de-creased in a dose-dependent manner in low , middle and high groups (P<0.05).Microscopic examination showed that the pathological changes of both kidney tissue and myocardium were significantly attenuated in low , middle and high dose group . Conclusion Dexmedetomidine can allenuate myocardial tissue injury induced by renal ischemia -reperfusion in a dose-dependent manner in rats and its mechanism may be involved with the inhibition of inflammatory factors .

OBJECTIVETo study the eletrogastrographic pattern in children diagnosed as functional dyspepsia (FD), with or without anorexia, and to investigate whether there is a link between the pattern of eletrogastrographic activity and anorexia.

METHODSThirty-two children with FD and receiving eletrogastrography (EGG) examination were classified to two groups: anorexia group (n=18) and non-anorexia (n=14). EGG was performed for 30 minutes during fasting and for 120 minutes postprandially. EEG variables measured included the percentage of normal gastric rhythm, the percentage of bradygastria and tachygastria, EGG domain frequency and its instability coefficient, and the fed-to-fasting ratio of the EEG domain power.

RESULTSThe percentage of abnormal gastric rhythm before a meal in the anorexia and non-anorexia groups was 77.8% and 78.6 % respectively (P>0.05); and that was 77.8% and 57.1% respectively after a meal (P>0.05). The fasting (31.6% vs 48.9%) and postprandial bradygastria frequencies (33.4 % vs 27.8 %) between the two groups were not significantly different. However, the percentage of tachygastria in the anorexia group was significantly higher than that in the non-anorexia group (fasting: 6.2% vs 0, P<0.01; postprandial: 14.8 % vs 1.9%, P<0.05). There were no significant differences in the instability coefficient of the dominant frequency and the fed-to-fasting ratio of the EEG domain power between the two groups both during fasting and after a meal.

CONCLUSIONSEGG abnormalities were associated with pediatric FD. Tachygastria occurred more often in the anorexia group than in the non-anorexia group.

Adolescent ; Anorexia ; physiopathology ; Child ; Child, Preschool ; Dyspepsia ; physiopathology ; Female ; Humans ; Infant ; Male ; Stomach ; physiopathology

OBJECTIVETo explore the causes and mechanisms of children elbow joint injury led to elbow varus.

METHODSOne hundred children with elbow varus causded by elbow joint injuries were retrospectively studied during January 2005 to April 2008 in department of child orthopedics involving 54 males and 46 females with an average age of 9.7 years old ranging from 7 to 16 years. The anterior-posterior and lateral position X-ray films of elbow joint continuous 12 to 18 months (means 15 months) of all the cases were collected. The postoperative X-ray films were observed to analyze the cause of elbow varus.

RESULTSThere were 81 cases caused by epiphyseal dysplasia, growth imbalance, included 47 cases of humeral supracondylar fractures, 16 cases of entire epiphysis separation of distal humerus, 11 cases of humeral lateral condyle fractures, 7 cases of humeral medial condyle fractures. There were 19 cases caused by ulna drift and rotation of the distal fracture end,the ulnaris cortibal bone crushing and collapse involving 11 of humeral supracondylar fractures, 2 of entire epiphysis separation of distal humerus, 5 of humeral lateral condyle fractures, 1 of humeral medial condyle fractures.

CONCLUSIONThere are two main factors of formation for the children elbow varus deformity: the main causes is epiphysial dysplasia after fracture and imbalance growth of epiphysis; the secondary reasons is ulnar inclination of the distal fracture, rotation of the distal fracture, fracture shift such as ulnar bone cortical extrusion collapse.

Adolescent ; Child ; Elbow Joint ; diagnostic imaging ; injuries ; pathology ; surgery ; Female ; Follow-Up Studies ; Fractures, Bone ; diagnostic imaging ; etiology ; surgery ; Humans ; Male ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVEAn unhealthy food consumption habit attributes to one of the etiology of gastro-esophageal reflux. The purpose of this article was to study the influence of food intake before going to bed on the nighttime gastro-esophageal reflux.

METHODSThirty-eight children with upper gastrointestinal symptoms were divided into two groups on the basis of taking (Group A, n=16) or not taking (Group B, n=22) food (non-stimulating) within 2 hrs before going to bed. All of them underwent 24 hr esophageal pH monitoring. The times of reflux episode, the longest duration of reflux, the times of reflux duration > 5 min, and the percentage of time of pH < 4 were compared between the two groups.

RESULTSThere were no significant differences in the parameters of pH monitoring between Groups A and B, with the times of reflux episode of 32 (21.5-43.5) vs 24 (15-37.3) , the longest duration of reflux of 6.6 (2.4-29.8) min vs 4.5 (2.5-13.2) min, the times of reflux episode longer than 5 min of 1.5 (0-3) vs 0 (0-3), and the percentage of time of pH < 4 of 4.3 (2.1-15.0)% vs 4.1 (2.0-7.2)% .

CONCLUSIONSNon-stimulating food intake before going to bed did not adversely affect the nighttime gastro-esophageal reflux.

Adolescent ; Child ; Esophageal pH Monitoring ; Feeding Behavior ; Female ; Gastroesophageal Reflux ; etiology ; Humans ; Male ; Time Factors

Objective To study ability of FibroScan (FS) in diagnosing the size of oesophageal varices (OV) in patients with HBV-related cirrhosis.Methods A total of 158 patients with HBV-related liver cirrhosis were enrolled in the study.The relation between the presence of OV assessed by endoscopy,and liver stiffness measurement by Fibroscan was studied,and ROC curves were drawn to assess the diagnostic ability of FS value.Results For the patients without OV,mild OV,moderate OV,and severe OV,their corresponding FS values were (21.7 ±9.9) kPa,(32.1 ± 13.6) kPa,(42.3 ±20.0) kPa and (54.5 ± 16.2) kPa,respectively.Significant difference was found among the groups (P ＜ 0.001) and also between any two groups (P ＜ 0.05).ROC curve for the diagnosis of with vs.without OV,＜ moderate vs.＞moderate OV,and ＜ severe vs.severe OV were 0.798 (95％ CI:73.1％-86.5％),0.823 (95％ CI:74.5％-90.0％)and 0.879 (95％ CI:80.8％-95.0％),respectively,with corresponding FS cut-off value of 23.3 kPa,31.5 kPa and 34.6 kPa.Conclusion Liver stiffness measurement allows to predict the sizes of oesophageal varices in patients with HBV-related cirrhosis.

AIMTo develop a rapid and feasible method based on micellar electrokinetic capillary chromatography (MECC) for the simultaneous determination of antiepileptic drugs (AEDs)--phenytoin (PHT), phenobarbital (PB), carbamazepine (CBZ), primidone (PRM) and clonazepam (CZP) in human plasma.

METHODSSeveral factors that impact the separation of AEDs with MECC were investigated, such as concentration of sodium dodecyl sulfate (SDS), buffer compositions, pH, organic modifier, internal diameter and temperature, and an optimized MECC running condition was obtained the running buffer consisted of 8 mmol x L(-1) phosphate, 3 mmol x L(-1) sodium tetraborate, and 50 mmol x L(-1) sodium dodecylsulfate (SDS) (pH 8.0), containing acetonitrile (ACN) (18%) as organic modifier. Detection at 210 nm, run at 25 kV at 30 degrees C in a untreated fused silica capillary (50/45.5 cm length, 50 microm ID).

RESULTSThe reproducibility of both migration time and relative peak area with MECC analysis were appropriate for the intra- and inter-assay coefficients. The evaluated drugs concentration intervals of PRM 1.0-40.0 microg x mL(-1), PB 1.0-60.0 microg x mL(-1), PHT 1.0-40.0 microg x mL(-1), CBZ 1.0-40.0 microg x mL(-1), CZP 0.2-8.0 microg x mL(-1) were linear with correlation coefficients higher than 0.999 1, and coefficients of the variation of the points of the calibration curve lower than 10%. The recoveries of AEDs varied from 80.0% to 100.0%, depending on the drug, with coefficients of the variation lower than 10.0%.

CONCLUSIONThe MECC technique is showed to be rapid, simple, efficient and low cost when applied to monitoring therapeutic drugs in patient treated with a combination of PHT and other AEDs such as hepatic enzyme-inducing agents.

Anticonvulsants ; blood ; Buffers ; Carbamazepine ; blood ; Chromatography, Micellar Electrokinetic Capillary ; methods ; Clonazepam ; blood ; Epilepsy ; blood ; Humans ; Hydrogen-Ion Concentration ; Phenobarbital ; blood ; Phenytoin ; blood ; Primidone ; blood ; Sensitivity and Specificity ; Sodium Dodecyl Sulfate

To study the effect of pulchinenoside (PULC) on the Frizzled (FZD) expression of adjuvant arthritis ( AA) rats. AA rats were prepared through the toe injection with complete Freund's adjuvant to culture fibroblast-like synoviocytes (FLS). The effect of the oral administration with PULC on the FZD8 expression was detected by the real time qPCR. The effect of FZD8 knockout on the expressions of IL-1, IL-6, IL-8 were detected by MTT and ELISA. The role of miR-375 in the abnomal expression of FZD8 was detected by the real time qPCR. The results showed signfiicant decrease in the FZD8 expression among AA rats, FLS proliferation ater FZD8 knockout and IL-1, IL-6, IL-8 expressions and notable increase in miR-375 expression after the oral administration with PULC. The up-regulated miR-375 expression can inhibit the FZD8 expression. PULC may inhibit the FZD8 expression by up-regulating the miR-375 expression.
Animals ; Arthritis, Experimental ; drug therapy ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Cell Surface ; genetics ; metabolism ; Saponins ; administration & dosage

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.

Objective To observe the sequence of fat deposit and its relationship with insulin resistance in SD rats fed by high fat diet.Methods Normal 8-week-old male SD rats were randomly divided into normal chow (NC,n=40)and high fat diet(HF,n=40)groups.Triglyceride(TG)in serum,liver and muscle were measured;glucose infusion rate(GIR)and the mRNA level of genes related to lipid metabolism in liver and muscle were determined in different stages.GIR was detected by eugiyeemic-hyperinsulinemic clamp for evaluating the insulin sensitivity.Gene expression was determined by real-time PCR.Results(1)As compared with NC group,serum TG was not increased after high fat feeding for4 and 8 weeks,it began to increase after 12 weeks [0.52(0.15-1.00) mmol/L vs O.31(0.09-0.53)retool/L, P0.05)in skeletal muscle.After 8 weeks,the expression of ACC1 in liver in HF group was increased by 20.6%,CPT-1 was decreased by 27.1%(P