Objective To investigate the brain magnetic resonance imaging (MRI) features and clinical manifesta-tions of the patients with citrullinemia, and to promote awareness of, early diagnosis of and better treatment for the disease.Methods One case with citrullinemia was reported, and other eight cases reported in the literature in nearly 14 years were reviewed.Results The case was a 15-month-old girl with type I citrullinemia diagnosed by the mutation analysis of the ASS1 gene performed in local hospital after birth. The patient was admitted to our hospital for recurrent lethargy for a year and the high level of blood ammonia (311 μmol/L, normal range 9-33 μmol/L). The blood ammonia reduced to normal on the 11th day after arginine treatment. On MRI scans, the diffusion weighted imaging (DWI) showed diffuse hyperintensity on bilateral frontal, parietal and temporal cortex, which indicated restricted diffusion due to cytotoxic edema. On the follow-up MRI after 10 day's treatment, the affected regions was similar but the intensity decreased compared to the previous scan,which accompanied by cere-bral atrophy. Eight cases in the literature were reviewed, and the clinical manifestations in these patients were lack of speciifcity, the most common features included feeding dififculties, lethargy, and vomiting. Brain MRI was performed on 7 cases, computed tomography (CT) was performed on 1 case, with the result of cytotoxic edema in 3 cases and atrophy in 2 cases.Conclusions Citrullinemia often lacks of speciifc symptoms in the early phase. Brain MRI could provide the clinician a valuable help for early diagnosis and treatment of this disease.

Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.

Animals ; Arginine ; pharmacology ; Blood Pressure ; drug effects ; Hypertension ; etiology ; metabolism ; physiopathology ; Male ; Oxidative Stress ; drug effects ; Rats ; Rats, Sprague-Dawley

Objective To investigate the correlation between the D-dimer level and the acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods The changes of D-dimer levels in 156 patients (AECOPD group) before and after treatment were measured and compared with the D-dimer levels of 156 healthy subjects(control group).Results The concentration of plasma D-dimer in the AECOPD group was (1.35 ± 1.46) mg/L,which was significantly higher than (0.25 ± 0.16)mg/L in the control group,and the difference was statistically significant(t =9.354,P ＜0.05).The level of plasma D-dimer in the AECOPD group was (0.69 ± 0.87)mg/L,and compared with (1.35 ± 1.46)mg/L before treatment,the difference was statistically significant(t =4.850,P ＜ 0.05).Conclusion D-dimer level is correlated to the condition of patients with chronic obstructive pulmonary disease,it can be used as one of the indicators to diagnose whether a patient is in hypercoagnlable state or suffers thrombotic diseases.

Objective To investigate the effect and side effects of flurbiprofen axetil combined with fentanyl in postoperative patient-controlled analgesia (PCA) after craniotomy.Methods 60 patients undergoing scheduled craniotomy were randomly divided into the treatment group and control group with 30 cases in each group, and received flurbiprofen axetil combined with fentanyl and only fentanyl respectively in PCA after craniotomy. The visual analogue scale (VAS), sedation score (SS) and the side effects were evaluated in 24 h after craniotomy.Results There was no significant difference in VAS between the two groups ( P>0.05). The SS, side effects such as nausea and vomiting in the treatment group were significantly less than that in the control group ( P<0.05).Conclusion Flurbiprofen axetil combined with fentanyl in PCA can reduce the side effects of fentanyl and offers overall favorable analgesic responses.

OBJECTIVE: To investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (HCN4) and connexin43 (Cx43) in the sinoatrial node of electric shock death. METHODS: As experimental group, 34 cases of electric shock death who had definite current mark evidence were selected from pathology department of Xuzhou Medical College from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. The expressions of HCN4 and Cx43 in the sinoatrial node were observed by immunohistochemical technology. RESULTS: HCN4 positive cells expressed in the cell membrane and cytoplasm of the sinoatrial node. Cx43 positive cells expressed in the cell membrane and cytoplasm of T cells and myocardial cells. The expression of HCN4 was significantly higher than that of the control group (P < 0.05) and the expression of Cx43 was significantly lower than that of the control group (P < 0.05). CONCLUSION The changes of HCN4 and Cx43 expressions in the sinoatrial node illustrate electric shock death might be related to the abnormalities of cardiac electrophysiology and conduction.
Connexin 43/metabolism* ; Cyclic Nucleotide-Gated Cation Channels ; Heart Rate ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels/metabolism* ; Immunohistochemistry/methods* ; Myocardium/metabolism* ; Myocytes, Cardiac ; Sinoatrial Node/physiopathology*

Objective To explore the brain changes of electroacupuncturing (EA) different acupoints of peripheral facial paralysis (PFP) with functional magnetic resonance imaging (fMRI). Methods Eighteen patients with left PFP were randomly divided into three groups. Six of them received electroacupuncturing left Dicang, 6 received electroacupuncturing left Hegu, and 6 received electroacupuncturing left Houxi. fMRI data were obtained from scanning of the whole brain. Functional data were processed by SPM99 software and functional responses were established with t-test analysis (P<0.05). Results Electroacupuncturing Dicang and Hegu on the left induced decreasing of signal in bilateral middle frontal gyrus, left cingulate gyrus, signal increased of right precentral gyrus, bilateral postcentral gyrus, left superior temporal gyrus and right insular, while electroacupuncturing Houxi on the left induced decrease of signal in bilateral inferior frontal gyrus, left lentiform nucleus, right middle temporal gyrus, right cerebellar tonsil, signal increased of right caudate head, right cingulate gyrus, brainstem, cerebellar vermis and right parahippocampal gyrus. Conclusion Electroacupunctuing Hegu and Dicang can cause corresponding functional activation in cerebrum, while electroacupuncturing Houxi can not, suggesting that there is association between cerebral and acupoint of owned meridian.

Objective To investigate condition of single drug or multiple drug resistance and sensitivities of different combinations of antibiotics in Helicobacter pylori (H.pylori) infected patients of different ages in Jiaxing City,Zhejiang Province.Methods From January 2007 to December 2011,a total of 6280 patients underwent gastroendoscopy examination were enrolled,the average age of them was 50.8 years old.Among them,129 cases were less than 20 years old,1802 cases were between 20 and 40,3016 cases were between 40 and 60,and 1333 cases were over 60.The mucosa of gastric antrum was collected for H.pylori culture.Drug sensitivity of isolated H.pylori strains was tested with metronidazole,amoxicillin and gentamycin,furazolidone,clarithromycin and levofloxacin.x2 test was performed for the comparison of drug resistance among different age groups.Results Among 6280 specimens,H.pylori culture of 2311 cases was positive (positive rate 36.80％).The positive rate of patients aged between 40 and 60 was the highest (38.43％,1159/3016),and that of patients over 60 was the lowest (33.76％,450/1333).The drug resistance rate of metronidazole in patients between 20 and 40 years reached 98.02％ (644/657) and was the highest.The drug resistance rate of clarithromycin in patents over 60 years old was the highest,which was 22.67％(102/450).The drug resistance rates of the levofloxacin,furazolidone,amoxicillin and gentamicin were low of all ages.Mixed resistance of two antibiotic appeared in 586 strains,mixed resistance rate of metronidazole and clarithromycin was the highest (259 strains,15.23 ％).Mixed resistance of three drugs appeared in 49 strains,mixed resistance rate of metronidazole,clarithromycin and levofloxacin was the highest (32 strains,12.88％).A total of 1691 strains were sensitive to the combination of amoxicillin and gentamycin,the sensitive was rate 99.41％.The sensitive rate of the combination of amoxicillin and furazolidone,gentamycin and furazolidone was both 94.24％.Conclusions Metronidazole presented high drug resistance of all ages,and should not be chosen.The combination use of amoxicillin and gentamicin is the ideal antibiotic combination for different ages.The combination of gentamycin and furazolidone is recommended for patients who are allergic to penicillin.

Objective To compare of intervention embolization and operation in the treatment of brain aneurysms.Methods 60 cerebral aneurysm patients using random number table method were divided into two groups each 30 cases,group A given intervention embolization;group B given surgical operation treatment.They were followed for 3months,the bleed Glasgow results score,matrix metalloproteinases 2(MMP-2) level change and the length of time were recorded.Results After treatment,A group total effective rate was 73.4％,postoperative treatment to bleed again rate was 10.0％ (3/30),B group was 76.7％,6.7％ (2/30),two groups had no statistically significant differences (x2 =0.09,0.22,all P ＞ 0.05 ) before treatment M MP-2 level between ;The two groups was statistically significant ( t =1.21,P ＞ 0.05 ) ;Two groups after surgical treatment 3 d MMP-2 levels were ( 20.1 ± 8.7 ) μg/L,( 35.7 ±8.9 ) μg/L respectively,which was statistically significant ( t =3.33,P ＜ 0.05 ).A group of hospitalization time (8.6 ±1.5 ) d,group B ( 13.2 ± 1.3 ) d,the difference between two groups was statistically significant ( t =3.18,P ＜ 0.05 ).Conclusion For brain aneurysm patients,the intervention embolization had no obvious difference in curative effect with operation,but could reduce the time in hospital and significantly reduced MMP-2 level.

Because of the rapidly rhythm of modern society, fast food and take-out become the main dining methods for most of young people,while the outside foods always have few types of foods and nutrition is not complete. Nutrient imbalances may cause many diseases such as gastrointestinal diseases,cardiovascular diseases,diabetes,obesity,and cancer.In this environment,health products have emerged.At present,there are a wide variety of health care products at home and abroad,which are broadly divided into three categories:traditional vitamins,emerging nutrient products,and extracts of natural plant active ingredients.In the early 1970s,the sales of health products in the United States had reached 170 million dollars.At present,it has nearly 100 billion dollars,which is almost 1/3 of the total food sales, people's demand for health products is increasing rapidly. In recent years, Chinese medicine health products become more popular in western,in fact, Chinese medicine health products have a long history of application in China and have a good reputation in the folk. Obviously, Chinese medicine health products have great potential for development.So this article mainly compared the de-velopment and state of health products between China and west countries.Based on the development of health products in western countries, this article analyzes the development trend and prospects for the development of Chinese medicine health products. It is roughly divided into three parts. The first part introduces the development reasons and history of western health products development.The sec-ond part introduces the history of Chinese health products and the current situation of Chinese medi-cine health products. The third part guesses the development trend of Chinese medicine health prod-ucts and provides some development ideas. The purpose of this airticle is to provide reference and ideas for the future research and development of traditional Chinese medicine health products.