Drugs, Chinese Herbal ; therapeutic use ; Gastrointestinal Hemorrhage ; drug therapy ; Humans ; Phytotherapy ; Rheum

Objective To investigate the expression and activation of MMP-2, MMP-9 in cerebral tissues of cerebral ischemia-reperfusion rats and the effects of doxycycline on the cerebral edema. Methods Cerebral ischemia-reperfusion model was established by middle cerebral artery occlusion (MCAO). The rats were randomly divided into a sham-operated and 6 reperfusion groups according to different reperfusion periods (3 h, 6 h, 12 h, 24 h, 72 h, and 120 h groups). Dry weight method was used to evaluate hemispheric water content of the ischemic side after treatment with doxycycline. Western blotting analysis and Gelatin zymography were used to determine the expression and activity of MMP-2 and MMP-9 in the ischemic cerebral tissues. Results The protein expression and activity of MMP-2 were significantly increased in the ischemia tissue at 3 h and 120 h after reperfusion(P<0.01) ; the protein expression and activity of MMP-9 began to increase at 6 h after reperfusion (P<0. 01) , reached the peak at 24 h, and then returned to the basal levels at 120 h after reperfusion (P>0.05). The hemispheric water content of the ischemic side gradually increased with reperfusion periods compared with the sham-operated group. Dexycycline significantly reduced the hemispheric water contents compared with the normal saline at the same time points(P<0.05 or P<0.01). Conclusion MMP-2, MMP-9 can induce vasogenic brain edema by degrading basal membrane of capillary vessel. The alteration of MMP-2, MMP-9 expression and activities are likely associated with brain edema during cerebral ischemia-reperfusion.

OBJECTIVETo summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach, and provide a reliable and efficient treatment method for scaphoid fractures.

METHODSFrom April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them, 10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X-ray and CT scan. In order to assess the function of wrist, all patients were calculated according to Krimmer's score postoperatively.

RESULTSThe follow-up period were from 5 to 18 months with an average of 10 months. At 3 months after operation,X-ray was re-checked every month. All the patients achieved bone union with a mean time of 10 weeks (ranged from 7 to 14 weeks) postoperatively. According to Krimmer's score, 14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred.

CONCLUSIONPercutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion, high bone union rate, and fewer complications.

Adult ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; physiopathology ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery

Acupuncture Therapy ; Aged ; Aging ; Hair Color ; Humans ; Male

Acupuncture Therapy ; Adult ; Aged ; Female ; Hiccup ; physiopathology ; therapy ; Humans ; Intestines ; physiopathology ; Male ; Middle Aged ; Qi ; Stomach ; physiopathology ; Young Adult

Apoptosis ; Cell Cycle ; Cell Differentiation ; Cell Proliferation ; Humans ; Neoplastic Processes ; Proto-Oncogene Proteins c-jun ; genetics ; metabolism ; physiology

AIM:By analyzing optical coherence tomography angiography (OCTA) characteristics of central serous chorioretinopathy (CSC) and comparing the differences of CSC between OCTA and indocyanine green angiography(ICGA), to explore if OCTA can substitute ICGA for diagnosis of CSC patients, and guide the treatment of photodynamic therapy (PDT).METHODS: We reviewed 30 eyes of 30 patients with CSC, who were diagnosed by fluorescein angiography (FFA) and ICGA at Beijing Tongren Eye Center from November 2015 to March 2016.All patients underwent best-corrected visual acuity (BCVA) measurement, intraocular pressure, slit-lamp examination, indirect ophthalmoscope, color fundus photography, FFA, ICGA and OCTA.FFA and ICGA were captured by Spectralis HRA + OCT (Spectralis HRA + OCT;Heidelberg Engineering, Heidelberg, Germany).OCTA was performed by RTVue XR Avanti device (OptovueInc, Fremont, CA) with 6mm×6mm Angio Retina mode.The software (version 2017.100.0.1;OptovueInc) automatically segmented the tissue into four layers, the characteristics of choriocapillaris layer were analyzed.At the same time, the differences between OCTA and ICGA images were compared among CSC patients.The maximum diameters and areas of both choroidal hyperperfusion in ICGA and high flow signal in OCTA were measured.Then, the paired t test was used to analyze the differences between the maximum diameter and area of OCTA and ICGA measurement.RESULTS: Among 30 cases, high blood flow signals of OCTA were clearly visible in 27 cases, namely the coarse grain region;the inner low flow signals surrounded by high blood flow signals were seen in 21 cases;the outer low flow signals surrounding high blood flow signals were seen in 7 cases.High blood flow signals of OCTA were corresponded with the choroidal hyperperfusion of ICGA images;among these 30 cases, there were low reflection shadows in choroidal hyperperfusion with ICGA for 22 cases, for 21 cases out of these 22 cases, low flow signals inside of high flow signals of OCTA could be seen;9 out of 30 cases, there were low reflection halo outside of choroidal hyperperfusion of ICGA, and 7 out of these 9 cases, low flow signals outside of high flow signals of OCTA could be seen;still for those 30 cases, leakage point in late ICGA could be seen with 14 cases, however, special flow signals in OCTA could not be seen for them.For ICGA, the maximum diameter of choroidal hyperperfusion was 1.589±0.295mm, whose area was 0.705±0.131mm2;while for OCTA, the maximum diameter of high flow signal was 1.576±0.293mm, whose area was 0.745±0.138mm2.By using paired t test, there was no statistical difference between the maximum diameter of choroidal hyperperfusion in ICGA and the maximum diameter of high flow signal in OCTA, nor difference between the area of ICGA and OCTA.CONCLUSION: The high flow signals can be clearly visible in OCTA, which are corresponded with choroidal hyperperfusion in ICGA.OCTA can substitute ICGA for diagnosis of CSC patients, and guide the treatment of PDT.

Air Pollutants, Occupational ; adverse effects ; analysis ; Dose-Response Relationship, Drug ; Dust ; analysis ; Humans ; Occupational Exposure ; adverse effects ; analysis ; Silicon ; adverse effects ; analysis ; Silicosis ; epidemiology ; United States ; epidemiology

Objective: To explore the influencing factors and pathways of clinicians' tumor marker prescription behavior in lung diseases, so as to find out the methods and measures to promote clinicians to optimize the tumor marker prescription. Methods: From July 24, 2017 to August 10, 2017, clinicians with willingness and the right of prescription mainly from hospitals in Shanghai and Beijing were invited to participate in survey on influencing factors of tumor marker prescription behavior in lung diseases. Based on the classical theoretical framework of IMB model, an IMB theoretical model of clinicians' tumor marker detection behavior was proposed. Statistical description and correlation analysis were performed by SPSS 24.0, and the IMB theoretical model was validated and corrected by AMOS 24.0. Results: The personal intention (r=0.251, P=0.000) and personal interest protection (r=0.178, P=0.007) had a significant positive correlation with information. Meanwhile, the personal intention (P=0.000) and personal interest protection (P=0.013) had a significant positive effect on behavioral skills, and the behavioral skills had a significant positive effect on tumor marker prescription behavior (P=0.000). There was no direct effect of information on behavioral skills, and motivation had no direct effect on tumor marker prescription behavior. Behavioral skills played a mediating role in the process of motivation influencing the tumor marker prescription behavior. Conclusion: The large percentage of irrational tumor marker prescription in lung diseases suggests the universality of inappropriate testing, which needs the joint efforts of governments, hospitals, clinicians and patients on improvement.