Objective To discuss the diagnosis and treatment of a variety of multiple nerve entrapment in the brachial plexus and around anterior and middle scalene muscles in 179 cases.Methods From July 2003 to January 2006,179 outpatients in our department were diagnosed as thoracic outlet syndrome(TOS)with a variety of symptoms of the nerve entrapment in the brachial plexus and around anterior and middle scalene muscles.They were treated with drugs,local block injections,or operations,depending on their severity of the condition. Results Of the 128 cases who were followed up for one to 29 months,the symptoms were significantly relieved with drugs and massage in 55 cases,with local block injection in 58 cases of whom 24 received the second in- jection,with operation in 15 cases of whom 10 returned to work.One of the operated cases reported symptoms of injury to the long thoracic nerve which responded to further therapy.The visual analogue scale(VAS)evaluations after the first injection were one point in two cases,two points in 16 cases,three points in 20 cases,four points in 12 cases,five points in three cases,six points in three cases,and seven points in two cases.The VAS scores after the second injection were two points in five cases,three points in 16 cases,and four points in three cases. Conclusions The entrapment of the anterior anti middle scalene muscles can affect many nerves around the muscles,and cause clinical symptoms other than the TOS ones.The conservative treatment,such as drug,massage, and local block injection,can work well.When the non-operative methods do not work,operation can be consid- ered.

Objective To explore the protective effect of astragalus injection(黄芪注射液)on cerebral cells after craniocerebral injury.Methods Sixty male Sprague-Dawley(SD)rats were randomly divided into five groups(each n=12).In the control group,only anesthesia and cranial bone surgery was performed, which did not impact on dura mater.In the model group,a freefall method was used to cause the left parietal lobe of brain limited contusion and saline was given.In the low,medium and high-dose astragalus injection (5,10,20 ml/kg)treatment groups,astragalus injection was injected intraperitoneally after injury at 30 minutes and 12 hours after injury respectively.After 24 hours of injury in each group,the rats were executed.The brain tissue from contusion was taken out and content changes of Ca~(2+),Mg~(2+),glutamate (Glu)and plasma endothelin(ET)were measured.Results In the model group,the Ca~(2+),Glu and ET contents in the rat brain tissues were significantly higher,but Mg~(2+)content was markedly lower than that of the control group(all P0.05).Conclusion Astragalus has a protective effect on nerve cells after craniocerebral injury.

Brain Abscess ; diagnosis ; etiology ; therapy ; Cerebellar Diseases ; diagnosis ; etiology ; therapy ; Ear Diseases ; complications ; Humans ; Male ; Young Adult

Humans ; Male ; Middle Aged ; Thyroid Cartilage ; abnormalities

OBJECTIVEThe purpose of this study was to develop RT- PCR assay for Rapidly detect and distinguish between Norovirus genogroup I and genogroup II with a pair of primers.

METHODSA pairs of primers specific to capsid prote in ORF2 gene of G I and G II Norovirus were dsigned according to the published complete genome sequence, with which the RNA of Norovirus was extracted and RT-PCR amplification. The sensitivity, specificity of the RT- PCR assay was estimated and apply it to the detection of Norovirus in clinical specimens.

RESULTSThe results showed that the assay possessed high specificity for Norovirus detection and without any evident cross-reaction with other viruses, including rotavirus, enteric adenovirus and hepatitis A virus. The detection limit of RT-PCR assay for Norovirus G I and G II were up to 100 pg/ml and 10 pg/ml respectively.

CONCLUSIONThe RT- PCR assay provide rapid and sensitive detection of Norovirus G I and G II and should prove to be useful for Norovirus diagnosis in the outbreaks of acute gastroenteritis.

Caliciviridae Infections ; diagnosis ; virology ; DNA Primers ; genetics ; Gastroenteritis ; diagnosis ; virology ; Humans ; Norovirus ; classification ; genetics ; isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; instrumentation ; methods

OBJECTIVETo investigate the therapeutic effect of Yiqi Huaju Recipe (YHR) combined with routine therapy on the blood pressure, the blood pressure variability and other cardiovascular risk factors in hypertension patients complicated with metabolic syndrome (MetS).

METHODSTotally 43 hypertension patients complicated with MetS were recruited in this study and randomly assigned to the treatment group (22 cases, treated with basic routine treatment +YHR) and the control group (21 cases, treated with basic routine treatment + placebo). The treatment course was 12 weeks. Detected were parameters such as 24-h ambulatory blood pressure monitoring (ABPM), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), homeostatic model assessment for insulin resistance (HOMA-IR), fasting glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PPG), fasting plasma insulin (FPI), serum lipid, etc.

RESULTSThe anthropometric parameters and plasma glucose levels (except HbAlc) were obviously lowered after treatment than before treatment in the treatment group (P < 0.01, P < 0.05). Besides, better effects were obtained in the WC, WHR, 2 h PPG, FPI and HOMA-IR (P < 0.05). The average blood pressure amplitude, the blood pressure variability, and blood pressure load at any time point were more obviously improved in the two groups after treatment than before treatment (P < 0.01, P < 0.05). Besides, partial indices were better in the treatment group than in the control group (P < 0.01, P < 0.05).

CONCLUSIONSYHR combined with routine therapy exhibited better effect on reducing the blood pressure amplitude, the blood pressure variability, and the blood pressure load in hypertension patients complicated with MetS. It could also effectively decrease the risk of other vascular disease.

Adult ; Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; Middle Aged

Animals ; Esophagus ; metabolism ; Glucagon-Like Peptide 2 ; pharmacology ; Intestinal Mucosa ; drug effects ; metabolism ; Intestine, Small ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Stomach ; metabolism

Effect of interleukin-6 receptor (IL-6R) antibody on polymethyl methacrylate (PMMA) bone cement-mediated expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-kappaB ligand (RANKL) in synovial fibroblasts was investigated. Synovial tissue obtained from total knee arthroplasty was digested and cultured. Inverted microscope was employed to observe the synovial cells and immunocytochemistry (SABC method) staining was used to identify synovial fibroblasts. This experiment was divided into three groups according to different culture media: PMMA group (75 μg/mL PMMA bone cement particles), IL-6R antibody group (10 ng/mL IL-6R antibody+75 μg/mL PMMA bone cement particles), and control group (no IL-6R antibody or PMMA bone cement particles). Influence of IL-6R antibody and PMMA on proliferation of synovial fibroblasts was measured by cell counting kit-8 (CCK-8). ELISA method was used to measure OPG and RANKL levels in culture solution. Fluorescence quantitative real-time PCR (FQ-PCR) was used to detect the expression of OPG and RANKL mRNA. After three consecutive passages, more than 95% of the primary synovial cells became long spindle fibroblast-like cells. SABC staining results showed that the fibroblast-like cells were negative for anti-CD68 antibody and positive for anti-vimentin antibody, with brown madder stained. CCK-8 test demonstrated that the absorbance (A) value at 450 nm was significantly lower in IL-6R antibody group than in PMMA group and control group (P<0.01), but there was no statistically significant difference in A value at 450 nm between the control group and PMMA group (P>0.05). Results of ELISA indicated that the expression of OPG was significantly higher in IL-6R antibody group than in PMMA group and control group (P<0.01). The expression of RANKL was inhibited (P<0.05), and the ratio of OPG/RANKL was significantly increased in IL-6R antibody group as compared with PMMA group and control group. There was no significant difference in the expression of OPG between control group and PMMA group (P>0.05), but the expression of RANKL was higher in PMMA group than in control group (P<0.05), and there was a significant difference in the ratio of OPG/RANKL between them (P<0.05). Results of FQ-PCR revealed the expression of RANKL mRNA was significantly inhibited (P<0.01) and the expression of OPG mRNA was significantly increased (P<0.01) in IL-6R antibody group as compared with PMMA group and control group. The expression of RANKL mRNA was higher in PMMA group than in control group (P<0.05), but the expression of OPG mRNA had no significant difference between them (P>0.05). IL-6R antibody could significantly increase the expression of OPG, but inhibit the expression of RANKL, which might provide a theoretical basis of molecular biology for the prevention and treatment of aseptic loosening of prosthesis.

OBJECTIVETo determine the outcome of combined anterior C2,3 reduction and fusion with posterior compressive C2 pedicle screw fixation for the management of unstable Hangman's fractures.

METHODSSixteen cases of unstable Hangman's fractures were retrospectively reviewed through X-ray, MRI and three dimensional CT scans. Pre- and postoperative radiographs were measured for translation and angulation of C2,3. Skull traction under extension poison was conducted in all the patients right after their admission. Then anterior C2,3 discectomy followed by interbody fusion, either with iliac autograft or with box cage, and locking plate fixation were performed in each case. Because dissatisfied reduction, mainly residual large fracture gap or kyphosis, was found by the C-arm fluoroscopy during operations, posterior compressive C2 pedicle screw fixation was performed in one stage. According to the Levine-Edwards classification, there were 12 cases of type II, 2 of type I a and 2 of type III in this group.

RESULTSFollow-up ranged 6-38 months, averaged 26 months. Fracture union and bone graft fusion were completed in an average of 4 months after operation. Complaints of neck pain and numbness of limbs disappeared in all patients after surgery, but range of neck motion decreased compared with normal people. Translation of C2 decreased from (4.2 +/- 1.4) mm preoperatively to (2.3 +/- 1.1) mm postoperatively, while angulation of C2,3 decreased from 8.6 degrees +/- 2.1 degrees preoperatively to 2.6 degrees +/- 1.0 degrees postoperatively. Both have statistical significance (P < 0.05). No implant failure or infection was observed.

CONCLUSIONSThe classification of Hangman's fracture should be modified in combination with MRI and CT scans to determine the stability of the fracture. Combined anterior C2,3 reduction and fusion with posterior compressive C2 pedicle screw fixation is the treatment of choice for patients with unstable Hangman's fractures.

Adult ; Aged ; Axis, Cervical Vertebra ; injuries ; surgery ; Bone Nails ; Cervical Vertebrae ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Spinal Fusion ; methods

OBJECTIVETo improve the outcome of the face-lift with a craniofacial contouring procedure.

METHODSThirty-seven patients aged 29-53 years (31 in female, 6 in male) were treated through a bicoronal incision. The facial tissue was lifted through a subperiosteal procedure and the facial skeleton was remodeled in three dimensions by osteotomies.

RESULTSThe results were satisfactory after the 3-12 months of the follow-ups.

CONCLUSIONSThe Face-lift combined with the facial aesthetic sculpturing may be more effective for the aging-face rejuvenating.

Adult ; Esthetics ; Female ; Humans ; Male ; Middle Aged ; Rhytidoplasty ; methods