OBJECTIVETo study clinical effects of minimally invasive, effective and economic operational method for the treatment of medial malleolus fractures.

METHODSFrom March 2008 to August 2010, 19 patients (12 males and 7 females, ranging in age from 17 to 42 years, averaged 31.7 years) with medial malleolus fractures were reviewed. Closed reduction and percutaneous internal fixation were applied, with a hollow compression screw inserted at the centre and perpendicularly to the fracture surface. A Kirschner wire was inserted through the cortical bone of opposite side and in accordance with the axis of inner malleolus. Postoperative therapeutic effect was evaluated by Kaikkonen sprained ankle scoring system and imageology examination.

RESULTSAll the patients got primary healing of incisions and were followed up, the duration ranged from 6 to 30 months, with an average of 18.7 months. All the patients obtained bone union. Clinical healing time ranged from 2.6 to 3.8 months, averaged 3.2 months. According to Kaikkonen scoring system, the results were rated as excellent in 5 cases, good in 10 cases, moderate in 3 cases, and poor in 1 case.

CONCLUSIONIt is a minimally invasive, effective and economic method to treat medial malleolus fractures by closed reduction and percutaneous internal fixation with hollow compression screw and Kirschner wire.

Adolescent ; Adult ; Ankle Joint ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Young Adult

OBJECTIVETo investigate the relationship between pathological abnormalities of placenta and small-for-gestational-age neonates.

METHODSOne hundred placentas of small-for-gestational-age (SGA group) and 200 appropriate-for-gestational-age (AGA group) with single living birth in third trimester were investigated by gross and microscopic examination. The AGA placentas were collected from 2 cases following every SGA placenta. All cases were collected from Shanghai Changning District Maternity and Infant Health Hospital from January 2010 to December 2011.

RESULTSThe gestational week, neonatal birth weight, full-term neonatal birth weight, the preterm birth rate and vaginal spontaneous delivery rate were significantly lower in SGA group than that in AGA group (P < 0.002). Full-term placental volume, placental weight and fetal placental weight ratio were lower in SGA group than that in AGA group (P < 0.05). Unusual insertion and torsion of umbilical cord were more common in SGA group (P < 0.05). Syncytial knots increase, avascular villi and villous infarcts were significantly higher in SGA group (P < 0.005), but there were no significant difference between SGA group and AGA group in intervillous thrombi, chronic villitis and chorangiosis (P > 0.05). Gestational hypertension disease and abnormality of fetal monitoring were more common in SGA group (P < 0.05).

CONCLUSIONSGestational hypertension disease is the main clinical cause of SGA. Some placental abnormality can affect the growth and development of intrauterine fetus.

Birth Weight ; Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Infant, Small for Gestational Age ; Placenta ; pathology ; Pregnancy ; Torsion, Mechanical ; Umbilical Cord ; pathology

OBJECTIVETo study the chemical constituents of Ishige okamurai.

METHODCompounds were isolated by Pyricularia oryzae bioassay-guided fractionation method in combination with extraction and partitionation as well as multi-chromatography. Their structures were determined by spectral analysis and chemical evidence.

RESULTSeven compounds were obtained and identified as (2S)-1-O-palmitoyl-2-O-(11Z-octadecenoyl)-3-O-beta-D-galacto-pyranosyl glycerol (I), (2S)-1-O-palmitoyl-2-O-myristoyl-3-O-(6-sulfo-alpha-D- quinovopyranosyl) glycerol (II), (2S)-1-O-palmitoyl-2-O-palmitoyl-3-O-(6'-sulfo-alpha-D- quinovopyranosyl) glycerol (III) and (2S)-1-O-palmitoyl-2-O-(11Z-octadecenoyl)-3-O-(6'-sulfo-alpha-D- quinovopyranosyl) glycerol (IV), stearic acid (V), methyl myristate(VI) and palmitic acid (VII).

CONCLUSIONCompounds I-VI were isolated from the alga for the first time while I, II and IV are new natural products. I-IV showed activity causing morphological abnormality of P. oryzae mycelia.

Antineoplastic Agents ; isolation & purification ; pharmacology ; Female ; Glycolipids ; chemistry ; isolation & purification ; pharmacology ; HL-60 Cells ; drug effects ; Humans ; Mitosporic Fungi ; drug effects ; Molecular Structure ; Phaeophyta ; chemistry ; Stearic Acids ; chemistry ; isolation & purification ; Tumor Cells, Cultured

OBJECTIVETo observe the effect of needling at Baihui(DU20), Shuigou(DU26) and Shenmen(HT7) on glucose metabolism in different regions of the brain in vascular dementia patients.

METHODSTen patients with vascular dementia were randomized into 2 groups, and the patients in the control group received the treatment with needling in the routine acupoints for hemiplegia (chosen from 6 Yang meridians of the hand and foot), while those in treatment group received needling at 3 additional acupoints, namely Baihui(DU20), Shuigou(DU26) and Shenmen(HT7), which were specific for dementia treatment. All the patients were examined by positron-emission tomography(PET) to detect the glucose metabolism in different brain regions before and after acupuncture treatment by means of semiquantitative analysis of the average values of radioactive count in the brain regions.

RESULTSNeedling at the additional 3 acupoints could obviously enhance glucose metabolism in the bilateral frontal lobes, bilateral thalamus, temporal lobe and lentiform nucleus on the uncompromised side.

CONCLUSIONThe effect of needling at Baihui(DU20), Shuigou(DU26) and Shenmen(HT7) on vascular dementia is closely related to improved cerebral glucose metabolism.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Brain ; metabolism ; Dementia, Vascular ; metabolism ; pathology ; therapy ; Female ; Fluorodeoxyglucose F18 ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; methods ; Radiopharmaceuticals ; Treatment Outcome

OBJECTIVETo evaluate clinical effects of lumbar spinal stenosis by endoscopic transforaminal decompression, and to provide a theory basis for selection of surgical candidates.

METHODSFrom June 2014 to January 2016, clinical data of 87 patients with lumbar spinal stenosis were retrospectively analyzed, including 45 males and 42 females, aged from 25 to 81 years old with an average of 55.14 years old; 8 cases on L₃,₄, 61 cases on L₄,₅, 18 cases on L₅S₁. All patients underwent percutaneous edoscopic transforaminal decompression. Clinical symptoms and nerve functions were evaluated by VAS, ODI before operation, 3 and 6 months after operation, MacNab scoring was used to evaluate clinical effects.

RESULTSPostoperative incision of 87 patients healed well without complications, and obtained more than 6 months follow-up. VAS score before operation, 3 and 6 months after operation respectively were 63.88±8.56, 13.22±8.24, 6.83±9.43 respectively;ODI score before operation, 3 and 6 months after operation were 59.96±12.60, 9.08±10.55, 5.64±6.84 respectively. There was statistical significance in VAS and ODI score compared before operation and 3 and 6 months after operation. According to MacNab scoring, 41 cases obtained excellent results, 30 good, 7 moderate and 9 poor.

CONCLUSIONSPercutenous endoscopic transforaminal decompression for lumbar spinal stenosis could reach good clinical effects if choosing appropriate indications. For patients with yellow ligament hypertrophy or combined with some ossified stenosis, insufficient decompression may result in poor therapeutic effects.

OBJECTIVETo estimate relative risk (RR) of cerebral vascular hemodynamics indexes (CVHI) accumulative score as well as some other risk factors of stroke.

METHODSA cohort study was carried out in 25 355 participants aged 35 and over in Northeast of China from 1994 to 2001. In the baseline survey, exposure rates of hypertension, diabetes, family history of stroke and hypertension, etc. were collected and CVHI was examined. CVHI accumulative score was synthesized according to contribution of single index. During the 7-year following up, 228 stroke cases were identified and stroke coming on was defined as the endpoint of observation. Uni-variable and multiple variables analysis were carried out for estimating RR of CVHI and other risk factors of stroke.

RESULTSUni-variables analysis indicated that RR (95% confidence interval, CI) of Hypertension, heart diseases, diabetes, family history of hypertension and stroke, overweight or obesity, alcohol intake, cigarette smoking and CVHI < 75 scores were 3.23 (2.48 - 4.20), 2.53 (1.92 - 3.33), 2.38 (1.55 - 3.64), 1.32 (1.02 - 1.72), 1.82 (1.37 - 2.41), 1.62 (1.25 - 2.11), 1.48 (1.07 - 2.04), 1.76 (1.34 - 2.31) and 7.30 (5.43 - 9.80) respectively. Cox regression analysis showed that CVHI below 75 points, family history of stroke, cigarette smoking, heart disease, hypertension, age and sex were the factors being selected in equation. There was a significant dosage response between the decrease of CVHI score and the increase of stroke risk. RR of stroke reached 12.55 when CVHI below 75 points and history of hypertension appeared in the same individuals.

CONCLUSIONAbnormality of CVHI score seemed to be the most important and independent factor among stroke risk factors. Decrease of CVHI score might serve as a marker of high risk and play important role in stroke, especially coexistence with hypertension.

Adult ; Aged ; Brain ; blood supply ; Cohort Studies ; Female ; Hemodynamics ; physiology ; Humans ; Male ; Middle Aged ; Regression Analysis ; Risk Factors ; Stroke ; etiology ; physiopathology

OBJECTIVE: To evaluate the efficacy and safety of tacrolimus in the treatment of children with myasthenia gravis (MG). METHODS: A total of 28 children with MG were treated with tacrolimus. MG-Activities of Daily Living (MG-ADL) scale was used to assess clinical outcome and safety after 1, 3, 6, 9, and 12 months of treatment. RESULTS: After tacrolimus treatment, the MG-ADL score at 1, 3, 6, 9 and 12 months was lower than that at baseline (P<0.05), and the MG-ADL score showed a gradually decreasing trend. The response rates to tacrolimus treatment at 1, 3, 6, 9, and 12 months were 59%, 81%, 84%, 88%, and 88% respectively. At 6, 9, 12, and 18 months of treatment, 4, 13, 14, and 15 children respectively were withdrawn from prednisone. No recurrence was observed during treatment. Major adverse reactions/events were asymptomatic reduction in blood magnesium in 5 children and positive urine occult blood in 1 child, which turned negative without special treatment, and tacrolimus was not stopped due to such adverse reactions/events. One child was withdrawn from tacrolimus due to recurrent vomiting. According to CYP3A5 genotypes, all of the patients were divided into two groups: slow metabolic type (n=19) and non-slow metabolic type (fast metabolic type + intermediate type; n=9). The non-slow metabolism group received a higher dose of tacrolimus, but had a lower trough concentration of tacrolimus than the slow metabolism group (P<0.05). The slow metabolism group had a higher response rates to tacrolimus treatment than the non-slow metabolism group (P<0.05). CONCLUSIONS Tacrolimus appears to be effective and safe in the treatment of children with MG and is thus an option for immunosuppressive therapy. CYP3A5 genotyping has a certain guiding significance for determining the dosage of tacrolimus.
Activities of Daily Living ; Child ; Humans ; Immunosuppressive Agents ; Myasthenia Gravis ; drug therapy ; Neoplasm Recurrence, Local ; Tacrolimus ; therapeutic use

OBJECTIVE: To compare the clinical efficacy between moxibustion and acupuncture for knee osteoarthritis (KOA), and to observe the effect on serum tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), superoxide dismutase (SOD) and malondialdehyde (MDA). METHODS: A total of 60 patients with KOA were randomized into a moxibustion group (30 cases, 2 cases dropped off) and an acupuncture group (30 cases, 2 cases dropped off). In the aucpuncture group, acupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Heding (EX-LE 2), Xuehai (SP 10), Liangqiu (ST 34), Zusanli (ST 36) and point on the affected side for 30 min.In the moxibustion group, moxibustion was adopted at knee for 60 min. The treatment was given once every two days for 4 weeks, totally 14 times. Before and after treatment, the western ontario and McMaster universities osteoarthritis index (WOMAC) score was compared, and the therapeutic effect was evaluated in the two groups. The contents of serum TNF-αand IL-1β, the activity of serum SOD and the serum level of MDA were detected in the two groups. RESULTS: Compared before treatment, the WOMAC scores and the contents of serum TNF-α, IL-1β and MDA after treatment were reduced (<0.05), the activity of serum SOD was increased (<0.05) in the two groups. In the moxibustion group, the WOMAC score and the contents of serum TNF-α, IL-1β and MDA after treatment were lower than the acupuncture group (<0.05), the activity of serum SOD was higher than the acupuncture group (<0.05). The total effective rate was 89.3% (25/28) in the moxibustion group, which was superior to 42.9% (12/28) in the acupuncture group (<0.05). CONCLUSION Moxibustion and acupuncture can relieve KOA symptoms, and the therapeutic effect of moxibustion is superior to acupuncture. The mechanism may be related to the reduction of serum inflammatory factor and oxidative stress factor.

As part of systematic research of Corydalis hendersonii,a typical traditional Tibetan herbal medicine with clearing heat,relieving pain,and lowering blood pressure effects,a novel isoquinoline alkaloid,named hendersine G was isolated from the ethanol extract of the whole plant by various chromatographic techniques,including silica gel column,reverse phase column (ODS),Sephadex LH-20,and semi-preparative HPLC.Its structure was elucidated by MS,NMR and other spectroscopic data analysis.Hendersine G can be regarded as a condensation product of a tetrahydroberberine and a succinic acid,however,its absolute configuration has not been determined due to its structural complexity and less obtained amount.This present study provides an inspiration for further exploration of novel molecules from C.hendersonii.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications