Objective:To explore the clinical signiifcance of the protection of superior petrosal vein (SPV) in the microneurosurgery for acoustic neuroma. Methods:From January 2009 to July 2011, 149 cases of acoustic neuroma microsurgery were observed. hTe difference in hematoma in surgical area, cerebellar hematoma and cerebellar edema were compared between a SPV without protection group (SPVWP group, n=8) and a SPV protection group (SPVP group, n=141). Results:In the 149 patients with acoustic neuroma, the SPV was reserved in 141 patients. In the SPVWP group (8 patients), hematoma in the surgery area occurred in 4 patients, cerebellar edema in 5, and cerebellar hemorrhage in 3. In the SPVP group (141 patients), hematoma in the surgery area occurred in 40 patients, cerebellar edema in 56, and cerebellar hemorrhage in 12. hTere was signiifcant difference in the incidence of cerebellar hemorrhage (χ2=3.84, P=0.05), no signiifcant difference in the incidence of hematoma in the surgical area (χ2=0.646, respectively, P=0.422), and no significant difference in the incidence of cerebellar edema (χ2=0.611, P=0.434) between the SPVWP group and the SPVP group. Conclusion:In acoustic neuroma surgery, the SPV should be protected, which may reduce the risk of cerebellar hemorrhage.

OBJECTIVERadial corrective osteotomy is an established but challenging treatment for distal radial malunion. There is an ongoing discussion about whether an opening or closing-wedge osteotomy between should employed. The purpose of the present study was to retrospectively compare the clinical and radio graphic results between conventional opening-wedge osteotomy and closing-wedge technique.

METHODSFrom January 2004 and December 2012,42 patients with extra-articular distal radial malunion were managed with corrective osteotomy and were followed for a minimum of one year. Twenty-two patients (5 males and 17 females, ranging in age from 25 to 75 years old) were managed with radial opening-wedge osteotomy and implanting of interpositional bone graft or bone-graft substitute, and twenty patients (4 males and 16 females, ranging in age from 19 to 79 years) were managed with simultaneous radial closing-wedge and ulnar shortening osteotomy without bone graft. The selection of the surgical procedure was determined by the surgeon. Each patient was evaluated on the basis of objective radio graphic measurements, and functional outcomes were determined on the basis of clinical examinations, including range of wrist motion, grip strength, pain-rating score, Mayo wrist score, and Disabilities of the Arm, Shoulder and Hand (DASH) score.

RESULTSThe mean duration of follow-up was 36 months (ranged, 12 to 101 months) for the opening-wedge cohort and 28 months (ranged, 12 to 87 months) for the closing-wedge cohort. The two techniques were comparable in terms of complications. Post-operative volar tilt and ulnar variance were improved significantly in each cohort. The ulnar variance was more frequently restored to within defined criteria (22.5 to 0.5 mm) in the closing-wedge cohort than that in the opening-wedge cohort. The post-operative mean extension-flexion are of the wrist and Mayo wrist score were significantly better in the closing-wedge cohort. Differences in the pronation-supination arc, grip strength, pain-rating score, and DASH scores between these two cohorts were not significant.

CONCLUSIONThe closing wedge osteotomy technique is an effective reconstructive procedure for the treatment of extra-articular distal radial malunion. It is significantly better than the opening-wedge osteotomy technique in terms of the restoration of ulnar variance, the extension-flexion arc of wrist motion, and the Mayo wrist score.

Adult ; Aged ; Bone Nails ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Osteotomy ; Radius Fractures ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Wrist Joint ; surgery ; Young Adult

OBJECTIVETo study the relationship between serum load level of HBV-DNA and therapeutic effect of oxymatrine in patients with chronic hepatitis B.

METHODSForty-four patients of chronic hepatitis B were divided into two groups, the treated group was treated with oxymatrine 0.4 g/d by intramuscular injection for 3 months, the control group was treated with some liver protecting agents to estimate the therapeutic effect. The serum level of HBV-DNA was determined by quantitative polymerase chain reaction (PCR) before and after treatment.

RESULTSThe seroconversion rate of HBV-DNA and HBeAg in the treated group was 43.47% and 43.47% respectively, which was obviously better than those in the control group respectively (P < 0.05), the quantity of HBV-DNA decreased after treatment from 10(6.83 +/- 1.27) copy/ml to 10(3.35 +/- 3.08) copy/ml. Among them, in patient with HBeAg negative conversion, the pretreatment quantity of HBV-DNA was 10(6.30 +/- 1.42) copy/ml, while in those with no HBeAg negative conversion, it was 10(7.23 +/- 1.23) copy/ml, the difference was significant.

CONCLUSIONOxymatrine is effective in treating chronic hepatitis B. The therapeutic effect is better for patients with lower quantity of serum HBV-DNA.

Adult ; Alkaloids ; therapeutic use ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; isolation & purification ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Polymerase Chain Reaction ; Quinolizines

A novel Aspergillus terreus strain M11 was isolated from the compost containing cellulose and identified. The isolate grow best at 45℃ and pH2.0. It was found that the activity of the CMCase was up to 3.680IU/mL with high heat stability and the optimal reaction conditions of the CMCase were at 60℃ and pH2.0.

Objective To provide vessel anatomical materials guidance for endovascular aortic repair,the branches artery of thoracic aortic was studied by CT angiography (CTA).Methods From January 2008 to February 2012,739 adult cases' CTA data were collected,all cases performing thoracic CTA in Wuhan General Hospital of Guangzhou Command.We measured the diameter and/or leugth of the ascending aorta,aortic arch and branches artery of aortic arch,and made an analysis.Results The aortic arch includes standard and variant types.Standard type is common,which accounted for 91.1％ of the total number,while variant type accounted for 8.9％.In the standard aortic arch of patients,the diameter of aortic arch above the opening of coronary artery (CA) was (35.7 ±4.3) mm,the diameter of ascending aortic arch at the opening of brachiocephalic trunk (BCT) was (33.6 ±4.2) mm,the diameter of aortic arch between the BCT and the left common carotid artery (LCCA) was (29.4 ± 5.7) mm,the diameter of aortic arch between the LCCA and the left subclavian artery (LSA) was (27.6 ± 4.2) mm,the diameter of descending aortic at the opening of the LSA was (25.4 ± 4.5) mm,the diameter of the head BCT from aortic arch was (12.9 ±0.9) mm,the diameter of the head LCCA from aortic arch was (8.5 ± 0.7) mm,the diameter of the head LSA from aortic arch was (10.4 ± 1.1) mm,the length of aorta between the CA and the BCT was (53.3 ±12.5) mm,the length of aortic between the BCT and the LCCA was (4.7 ± 1.5) mm,the length of aortic between the LCCA and the LSA was (7.9 ± 2.6) mm,the length between the opening of BCT and the right subclavian artery (RSA) was (41.1 ± 8.2) mm,the length between the opening of LSA and the opening of left vertebral artery was (38.5 ±5.7) mm,the angle between the horizontal of BCT and the LCCA and the sagittal plane was (71.2 ± 7.2) °,the angle between the plane of LCCA and the LSA and the plane of sagittal was (31.1 ± 2.9)°.Conclusions The CT data of the thoracic aorta can be used as reference for production of stents and guide releasing the stents in endovascular repair.

Objective To evaluate the hemodynamic changes in patients with middle cerebral artery (MCA) stenosis pre- and post-stenting by transcranial color-coded and pulsed-Doppler sonography.Methods Thirty patients with middle cerebral artery stenosis were included.Two-dimensional,color-coded and pulsed-Doppler sonography were used to monitor the morphologic and hemodynamic changes of the MCA before,in the middle of,and after the endovascular stenting operation.All patients were verified by digital substract angiography.Results The hyper-echoic stent grafts and also the size and location of the stent were clearly shown by two-dimensional ultrasonography in 28 patients.The systolic,diastolic and the timeaveraged maximal flow velocities significantly decreased both instantly and 3 - 7 d after the stenting.Specifically,the systolic peak flow velocity of the MCA dramatically decreased immediately after the stenting [(151.43 ± 25.14) cm/s vs (286.13 ± 57.38)cm/s,P ＜0.05],and showed a further decrease after 3 - 7 d [(108.80 ± 9.95) cm/s vs (151.43 ± 25.14) cm/s,P ＜0.05].Conclusions Transcranial color-coded and pulsed-Doppler sonography could be used to evaluate the hemodynamic changes after MCA stenting,and could be considered as the first choice of method for evaluating the therapeutic outcome of stenting.

Objectives To investigate the efficacy and toxicity of bortezomib based combination therapy for Chinese patients with relapsed or refractory multiple myeloma(MM),and to determine the combination regimen,dosage and cycles in application of bortezomib for MM therapy.Methods Forty-six patients with refractory or relapsed myeloma were treated with bortezomib(1.3 mg/m2)as an intravenous bolus twice weekly for 2 weeks on day 1,4,8,and 11 in a 3-4 week cycle,in combination with dexamethasone,dexamethasone plus thalidomide, CD(C-cytoxan,D-dexamethasone),MD(M- mitoxsnteone),DCEP(E-etoposide,P-platinol),and DT-PACE regimens(T-thalidomide,A-adriamycin). Response to bortezomib was evaluated according to the criteria of the International Myeloma Working Group (IMWG)before initiation of each cycle.Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0.Forty-nine matched patients with relapsed and refractory MM who received thalidomide based combination therapy were used as a historical control group.Results Among 43 of the 46 patients whom could be evaluated,the overall response rate was 72.1%(the control group was 51.0%,P＜0.05),including complete response in 5 patients(11.6%),very good partial response in 12 patients(27.9%),and partial response in 14 patients(32.6%).The overall response rate after one and two cycles was 30.2%and 58.1%(P＜0.05),respectively.The frequent adverse events were thromboeytopenia(62.8%),fatigue(55.8%),nausea(51.2%)and peripheral neuropathy (30.2%);all of the events could be tolerated.The most common adverse event in the control group was constipation(69.4%),followed by fatigue(59.2%)and dizziness(46.9%).Conclusions Bortezomib based combination therapy is a new effective therapy in relapsed or refractory myeloma patients with a higher response rate and difierent toxicities as compared with thalidomide based combinations.

Objective To discuss the preservation and clinical significance of petrosal vein in microsurgical operation of acoustic neuroma. Methods 147 patients with acoustic neuroma were operated, with internal decompression of the tumor firstly then dissected the tumor with surrounding structures, the petrosal vein were protected well in 143 cases and failed to protect in 4 cases. Results No hemorrhagic infarction in cerebellar was observed in 143 cases with intact petrosal vein. One case occurred with extensive cerebellar edema, which has gait disturbance after 18 months follow-up. The other three cases occurred with vein infarction and hemorrhagic edema after petrosal vein damage. One was dead and the other two were recovered well after decompression of posterior cranial fossa. One has no significant neurological deficit after 33 months follow-up, while the other has difficulty in line walking after 12 months follow-up. Conclusion Petrosal vein should be well protected in the operation of acoustic neuroma, the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.

OBJECTIVETo explore the relationship between angiotensin converting enzyme (ACE) gene single nucleotide polymorphisms (SNP) and premature coronary heart disease (PCHD) patients with blood stasis syndrome (BSS).

METHODSrs4343, rs4293, and rs4267385 were selected at SNP from ACE gene. Allele and genotype were detected. Frequencies of allele and genotype were compared by using time-of-flight mass spectrometry technique (TOF-MS).

RESULTSCompared with the healthy control group, genotype of rs4293 and rs4267385 in ACE gene were similar, but there was statistical difference in polymorphisms and allele frequencies of rs4343 in the I and II group (P < 0.05, P < 0.01). The frequency of G allele was higher in the 3 groups than in the healthy control group (P < 0.05, P < 0.01). The relative risk analysis showed that the risk for PCHD occurrence in G allele carriers at rs4343 (GG +AG) was 3. 6 times the risk in non-G allele carriers (95% CI: 1.224-10.585, P = 0.02). There was also statistical difference in sex, age, TC, and TG after adjusted Logistic regression analysis (OR = 3.994, 95% CI: 1.230-12.974, P = 0.021).

CONCLUSIONThe polymorphism at rs4343 (G2350A) might be one of risk factors for PCHD occurrence, but not a predisposing factor for PCHD patients of BSS.

Alleles ; Case-Control Studies ; Coronary Artery Disease ; genetics ; Gene Frequency ; Genotype ; Humans ; Medicine, Chinese Traditional ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Single Nucleotide ; Risk Factors

Objective To study the inhibitory effect of pterin acid (PTA) against ricin and recombinant ricin A chain protein. Methods Luciferase protein synthesis inhibition assay in a cell-free system and in vitro cytotoxicity experiments were performed to assess the biological activity of ricin and rRTA treated with PTA.Results The result showed that PTA could significantly inhibit the activity of ricin and rRTA in a dose-dependent manner.Conclusion PTA might be used as a small molecular probe to develop an evaluating system for ricin/RTA small molecular inhibitor in vitro. The cell-free system adopted in the current study could also serve as a necessary basis for screening some novel small molecular compounds against ricin and RTA in the future.