?AlM: To investigate the clinical characteristics and influencing factors of chronic renal failure ( CRF) patients with dry eye, and to provide clinical reference.?METHODS:Sixty-one cases (122 eyes) of patients with CRF ( CRF group ) and 61 cases ( 122 eyes ) of healthy persons ( control group) were carried out on Schirmer ▏test ( S▏t ) , break-up time of tear film ( BUT ) , corneal fluorescein staining ( FL) , test results of two groups were compared and related factors of dry eye in CRF patients were analyzed.?RESULTS: The results of S▏t and BUT in CRF group were lower than that in the control group (P<0. 05). The proportion of tear secretion reduce in CRF group ( S▏t<10mm/5min) was 49. 2% ( 60/122 ), which was higher than that in the control group ( 10. 0%, 12/122 ), the difference was statistically significant ( X2 = 45. 39, P <0. 05). The percentage of instability of tear film in CRF group (BUT≤10s) was 75. 4% (92/122), which was significantly higher than that in the control group (27. 0%, 33/122) (X2=57. 1, P<0. 05). The positive rate of corneal FL was 37. 7% (46/122), which was higher than that of the control group (10. 7%, 13/122), there was a statistically significant difference (X2= 24. 34, P<0. 05).?CONCLUSlON:CRF patients with a decrease in tear film stability and tear secretion are susceptible population to dry eye, clinically should be paid attention to the treatment.

Objective To explore the clinical diagnosis,medication,curative effect,and prognosis of lymhocyte subsets and humoral immunity in children with Kawasaki disease(KD)complicated with coronary artery dilatation.Methods One hundred and seventy-one children(age of 4 months to 9 years)from Jun.2000 to Dec.2007 with KD in Capital Institute of Pediatrics were taken as research objective,65 healthy children(age of 5 months to 7 years)were taken as controls,the difference of the level variation of lymhocyte subsets and humoral immunity was detected and analyzed between them.The flow cytometry and scattering turbidimetry method were used to detect the numbers of T cell subsets [CD3+,CD3+CD4+,CD3+CD8+,CD19+,natural killer(NK)cell] and levels of immune globulin(IgG,IgA,IgM)of the peripheral blood of 171 patients,compare them with those of the control group,and compare them between patients with and without coronary artery dilatation.Results Compared with control group,in the acute period of KD the levels of CD3+,CD3+CD4+ decreased significantly(t=0.01,0.02 Pa0.05);of all the 171 children patient,53 cases were coronary artery expansion patients.Compared with non-expansion patients,levels of CD4+/CD8+,CD3+CD8+,IgG of coronary artery expansion patients were significant different and had statistical difference(t=0.02,0.04,0.03 Pa

OBJECTIVETo explore surgical treatment of gliomas involving the supplementary motor area (SMA) in the superior frontal gyrus.

METHODSClinical data and follow-up outcome of 16 patients with low graded astrocytomas involving the supplementary motor area were analyzed.

RESULTSSMA syndrome was developed in 6 patients in whom the posterior tumor resection line was at a distance of more than 1 cm from the precentral sulcus and resolved after 12 months. Hemiplegia occurred however in 8 patients in whom the resection line was less than 1 cm to precentral sulcus and only resolved in 3 patients during follow period 12 months.

CONCLUSIONSWhen the resection is performed at a distance of less than 1 cm from the precentral sulcus, surgery for gliomas of involving the supplementary motor area in the superior frontal gyrus may be result in permanent morbidity.

Adult ; Astrocytoma ; surgery ; Brain Neoplasms ; surgery ; Female ; Follow-Up Studies ; Frontal Lobe ; surgery ; Humans ; Male ; Middle Aged ; Movement Disorders ; etiology ; physiopathology ; Neurosurgical Procedures ; adverse effects ; methods ; Recovery of Function ; Speech Disorders ; etiology ; physiopathology

OBJECTIVETo summarize the clinical application result of the selective nerve root blocks in limited operation of the lumbar spine.

METHODSFrom January 2008 to October 2012,68 patients with lumbar spinal canal stenosis with multiple levels were underwent the selective nerve root blocks in limited operation of the lumbar spine,including 47 males and 21 females with an average age of 56 years old ranging from 45 to 80. After never roots blocks,64 cases were positive for limited operation of the lumbar spine; the other 4 cases were negative and abort the operation.

RESULTSThe nerve roots block operation smoothly and no complications related to the nerve roots block occurred. There was no neurologic injury complication in this study. Follow-up period ranged from 16 to 45 months postoperatively (means, 32 months). The recovery effect was calculated with Macnab scores, the result was excellent in 44 cases, good in 18 cases, poor in 1.

CONCLUSIONOperative treatment for lumbar spinal canal stenosis with multiple levels is focused on the areas causing symptomate neural compression rather than prophylactic decompression at areas of nonsymptomatic disease. Application of selective nerve root blocks can accurately judge the responsible vertebral body and pain source and improve the curative effect of limited operation of the lumbar spine

Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Nerve Block ; methods ; Spinal Nerve Roots ; Spinal Stenosis ; surgery

OBJECTIVETo summarize the clinical application results of the repair soft tissue defect in contralateral leg with a cross-leg soleus muscle flap pedicle transplantation.

METHODSFrom January 2008 to January 2013, 8 patients with soft-tissue defect in lower leg underwent reconstruction with a cross-leg soleus muscle flap pedicle transplantation (without microvascular anastomoses). There were 7 males and 1 female, aged from 20 to 49 years old with an average of 31.8 years. The operative time after injury was from 2 to 8 weeks with the mean of 46 days. The soleus muscle flap was transposed across to the contralateral leg defect area, then immediate to perform the coverage of the muscle flaps by a meshed split-thickness skin graft. The donor site was closed directly.

RESULTSAll the muscle flaps had survived completely. In one case, recipient area edge had a less exudate from drainage hole everyday, the incision spontaneously was healed after 2 week's changing dressing. Follow-up period ranged form 1.5 to 4 years with an average of 2.5 years postoperatively. The tibia and fibula fractures were healed well. A good contour was achieved at the recipient area. According to LEM standard, 2 cases got excellent results, 5 good and 1 fair.

CONCLUSIONSoleus flap pedicle transplantation is very suitable to repair the soft tissue defect of the injuried leg only one main blood vessel, and can reduce the damage of donor area.

Adult ; Female ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Muscle, Skeletal ; Soft Tissue Injuries ; surgery ; Surgical Flaps

OBJECTIVETo explore the status of HER2 gene amplification and its product HER2 protein expression in gastric carcinoma, so as to aid in patient selection for anti-HER2 targeted chemotherapy.

METHODSEighty-five cases of gastric carcinoma biopsy tissues were collected. The status of HER2 gene amplification was detected by dual in situ hybridization (dual-ISH). And HER2 protein was detected by immunohistochemistry.

RESULTSHER2 gene amplification was detected in 10/85 (11.8%) cases of gastric carcinoma, and no amplification was detected in 75/85 (88.2%) cases. In the 10 cases with HER2 amplification, HER2 immunoreaction scorings of 3+, 2+ and 0/1+ were present in 7, 2 and 1 cases, respectively. In the 75 cases without HER2 amplification, HER2 immunoreaction scorings of 3+, 2+ and 0/1+ were present in 0, 18 (24.0%) and 57 (76.0%) cases, respectively. Histologically, most gastric carcinoma with amplification of HER2 gene was moderately differentiated tubular adenocarcinoma.

CONCLUSIONSHER2 gene dual-ISH technique is a reliable and objective method for detecting HER2 gene amplification in gastric carcinoma biopsy. Clinically, only few gastric carcinomas show HER2 gene amplification and are suitable candidates for anti-HER2 targeted chemotherapy.

Adenocarcinoma ; genetics ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Female ; Gene Amplification ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; In Situ Hybridization ; methods ; Male ; Middle Aged ; Receptor, ErbB-2 ; metabolism ; Stomach Neoplasms ; genetics ; metabolism

OBJECTIVETo explore clinic characteristics of proximal anterior cerebral artery aneurysms and analyzed operative techniques.

METHODSA review was performed of a total of 362 patients whose aneurysms were surgically treated from June 1995 to December 2003, the morbidity of A(1) aneurysms was 2.2%. To reviewed clinical data of 8 proximal anterior cerebral artery aneurysms patients.

RESULTSAll of the aneurysms developed at the takeoff point of perforating arteries, the recurrent artery of Heubner in three cases, the medial proximal lenticulostriate artery in five cases. Six cases aneurysms projected posteriorly, two cases projected inferiorly in the surgical field. The shape of the aneurysms was saccular in all cases and diameter no larger than 5 mm in six cases. Patients were clipped satisfactorily, excellent condition in 7 patient, good condition in one.

CONCLUSIONIt is important to preserve the perforating arteries and use suitable clip by avoiding cerebral ischemia.

Adult ; Aged ; Anterior Cerebral Artery ; surgery ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo measure the social productivity loss and negative effect to economic development due to malnutrition in view of quantitative analysis.

METHODSUsing the data of childhood stunting and population anemia status, collected by 2002 National Nutrition and Health Survey to analyse the effect on present and future productivity. PROFILES model was used to estimate two kinds of productivity losses: "Future productivity loss" was figured out based on the data of stunting and anemia status in 0-5 year-old children while "Current productivity loss" was from anemia data of the adults.

RESULTSIf current prevalence levels of malnutrition remained unchange over the next ten years (from 2002 to 2012), the total net present value of future productivity lost would be 281.7 billion Yuan (RMB), equivalent to 2.70 % of the Gross Domestice Product( GDP) in 2002, with the productivity losses due to stunting, anemia in adults and children were 0.15 % , 0.46 % and 2.09% of the 2002 GDP, respectively. All the results of calculation mentioned above was restricted with the same assumption - the ignorance of the real cost.

CONCLUSIONThe social economic development and the improvement of nutrition program would have a huge effect to population nutritional status. The social benefit and return on investment should be significant.

Adult ; Anemia ; economics ; epidemiology ; China ; Cost of Illness ; Economics ; trends ; Efficiency ; Humans ; Malnutrition ; economics ; epidemiology ; Prevalence ; Social Conditions

OBJECTIVETo evaluate influences on intestinal structure and myoelectric motility between modified uncut jejunal loop and Roux-en-Y procedures for biliodigestive anastomosis.

METHODSFifteen rabbits were randomized in modified uncut jejunal loop group, Roux-en-Y group and control group. Traced fasting slow-wave frequency (SWF) before biliodigestive diversion and 25 d postoperative (POD25) during laparotomy. Before the second laparotomy on POD21, the fasting SWF, percentage of abroad migrating myoelectric complex (MMC%), the postprandial spike potential frequency (SPF) and percentage of abroad propagation (SP%) were recorded in vivo. Compared myoelectric recordings according to parameters above. On POD90, harvested the stitched ligation of ascending loop and part of descending loop in uncut group, and biliary limb in R-Y animals, which assessed under HE, c-kit labeling immunohistochemical staining and transmission electron microscope(TEM).

RESULTSOn POD25, SWF declined mildly in uncut group (8.4%) and markedly in R-Y group (23.8%) respectively. The difference was significant (P<0.05). Before laparotomy on POD21 when abdomen closed, between uncut and control animals, there were statistical difference in fasting SWF and postprandial SPF (P<0.05), while no significance in MMC% and SP% (P>0.05). Moreover, differences of each parameters between R-Y group and control or uncut group were markedly statistical (P<0.01). Abroad myoelectric propagation through the ligated segment can be observed in uncut animals. Meanwhile, ectopic pacemaker was detected locating in the proximal segment of the Roux limb and triggering retrograde propagation in R-Y animals. On POD90, no recanalization were observed In uncut animals. Furthermore, occluded lumen with mild atrophic mucosa under microscope and c-kit labeling cells located in the inner circular muscle layer were observed, which proven to be Interstitial cells of Cajal (ICCs) by TEM. In R-Y animals, lumen of the Roux limb dilated. There's no significant difference in c-kit labeling area between R-Y and uncut animals by image analysis system. Reductions of processes and intercellular gap junction in ICCs, and loose interconnections between ICCs and SMCS or nerve endings were observed in R-Y animals.

CONCLUSIONSImpaired gastrointestinal motility after the Roux-en-Y procedure may due to the aberrant interstitial cells of Cajal. Modified uncut technique reveals a reliable and effective alternative for biliodigestive reconstruction.

Anastomosis, Roux-en-Y ; Animals ; Electrophysiology ; Female ; Intestines ; metabolism ; physiology ; surgery ; ultrastructure ; Jejunostomy ; methods ; Peristalsis ; physiology ; Postoperative Period ; Proto-Oncogene Proteins c-kit ; metabolism ; Rabbits ; Random Allocation

OBJECTIVETo investigate whether the polymorphisms of matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9) promoters contribute to the development and progression of colorectal cancer in Chinese population.

METHODSthe PCR-based denaturing high-performance liquid chromatography or PCR-restriction fragment length polymorphism technique respectively was applied to analyze the MMP-2 -1306C/T and MMP-9 -1562C/T polymorphisms in normal group (126 individuals) and colorectal cancer group (126 cases). Genotype frequencies were compared between patients and matched controls, and the association of genotypes with clinical-pathological parameters was studied.

RESULTSThe frequency of the CC genotype in the MMP-2 gene polymorphism was significantly increased in colorectal cancer patients when compared with controls (P<0.05), and individuals with the CC genotype had an increased risk of developing colorectal cancer compared to those with CT+TT genotypes (OR: 1.959; 95%CI: 1.055-3.637). Significant correlation was found between the depth of tumor invasion and MMP-2 -1306C/T polymorphism in colorectal cancer patients. However, the genotype frequencies of MMP-9 -1562C/T in colorectal cancer patients were similar to those in control subjects.

CONCLUSIONOur results indicate that MMP-2 -1306 C/T polymorphism may be associated with genetic susceptibility to colorectal cancer and the invasive capability of colorectal cancer in Chinese patients. And it is easier for the CC genotype cancer to invade through bowel wall.

Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Colorectal Neoplasms ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Matrix Metalloproteinase 2 ; genetics ; Matrix Metalloproteinase 9 ; genetics ; Middle Aged ; Polymorphism, Genetic ; Statistics as Topic