Iatrogenic vertebral artery injury is a rare complication in cervical spine surgeries,the consequences of which may be catastrophic.With the extensive development of cervical spine surgeries and application of diverse new internal fixations of cervical spine,there is a potential increase of risk of iatrogenic vertebral artery injury,which should be paid attention to.This article reviews the rate,cause and management etc.of iarogenic vertebral artery injury.

In adipose tissues from sreater omentum of patients with type 2 diabetes,the mRNA and protein expressions of human rearranged immunoglobulin?light chain (HSIGVL) 022 were measured by the fluorescent quantitative RT-PCR and immunohistochemistry respectively.The results showed that mRNA and protein levels of HSIGVL022 were up-regulated in patients with type 2 diabetes.The mRNA level of HSIGVL022 was linearly correlated with insulin resistance index,suggesting that this gene may play a role in the pathogenesis of insulin resistance and type 2 diabetes.

Objective To investigate the situation of prevalence,treatment and control of hypertension in patients with chronic kidney disease(CKD)by CROSS-sectional study. Methods Nine hundred out-patients with CKD in our department from November 2006 to March 2007 were enrolled in the study,including 480 male and 420 female.Among 900 CKD cases,354 patients underwent maintenance dialysis,including 228 on hemodialysis and 126 on peritoneal dialysis.Results The prevalence of hypertension in CKD patients was 80.2%(nude 83.5%vs female 76.4%,P<0.01).The prevalence of hypertension in patients on dialysis was significantly higher than that in non-dialysis patients(90.1%vs 73.8%,P<0.01),but there was no significant difference between hemodialysis and peritoneal dialysis cases.Antihypertensive treatment rate was 92.4%in CKD patients with hypertension.and was significantly higher in patients on dialysis than that in non-dialysis patients(95.6%vs 89.8%.P<0.01).The control rate according to current recommendations for CKD patients (BP<130/80 mm Hg) was very low. Control of both SBP and DBP was only achieved in 20.4% of non- dialysis patients. The control rate of hypertension (BP< 125/75 mm Hg) in patients with proteinuria >1 g/24 h was 8.4%. The proportion of dialysis patients with BP<140/90 mm Hg was significantly lower than that of non-dialysis patients (45.2% vs 55.5%, P<0.01). The percentage of hemodialysis patients with BP < 140/90 mm Hg was significantly higher than that of peritoneal dialysis patients (49.8% vs 36.5%, P<0.05). The prevalence of hypertension was associated with the decrease of renal function and the increase of age. The prevalence of hypertension in diabetic nephropathy was higher than that in primary glomerular diseases. Patients received 1, 2, 3 and 4 or more kinds of antihypertensive drugs accounted for 37.2%, 37.5%, 19.3% and 5.9% respectively. The combination of calcium channel blocker (CCB) and renin-angiotensin-aldosterone system (RAAS) inhibitors was more frequently used in CKD patients. The CCB was the most frequently prescribed drug (74.1% ), followed by angiotensin Ⅱ receptor blockers (ARB) (48.4%), angiotensin-converting enzyme inhibitors (ACEI) (25.6%) and alpha, beta-blockers (24.7%). Conclusions The prevalence of hypertension in CKD patients is quite high, which is associated with the progression of renal function, increase of age, the type of underlying kidney disease, obesity and diabetes mellitus. The control of hypertension is unsatisfied in CKD patients, especially in dialysis patients and those with overt proteinuria.

ObjectiveTo compare the efficacy and safety of intermittent patient-initiated single-dose antibiotic prophylaxis and continuous antibiotic prophylaxis for the prevention of recurrent urinary tract infection (UTI) in postmenopausal women. MethodsA randomized controlled clinical trial was conducted for the prevention of recurrent urinary tract infection. Single dose of antibiotic was given every night in continuous antibiotic prophylaxis group and every time after exposure to conditions predisposed to UTI in intermittent antibiotic prophylaxis group. The duration of prevention was 12 months in both groups. ResultsThe effective rates of intermittent antibiotic prophylaxis and continuous antibiotic prophylaxis were 71.0% and 81.8% respectively (P＞0.05). The incidence of gastrointestinal adverse reaction in intermittent antibiotic prophylaxis group was significantly lower than that in continuous antibiotic prophylaxis group (7.7% vs 28.6%,P＜0.05). ConclusionsCompared with continuous antibiotic prophylaxis, intermittent patient-initiated single-dose antibiotic prophylaxis is a better prophylaxis with less gastrointestinal adverse reactions for the prevention of recurrent urinary tract infection in postmenopausal women.

Objective: To determine protein binding characteri stic and signal transmission pathway of melatonin（Mel） receptor(MR) in human e mbryonic peripheral organ tissues. Methods: MR was measured by radio ligand-binding assay and the effect of GTPγS on melatonin specific bindi ng was studied. Results: Mel specific binding sites were det ermined in 16 kinds of human embryonic tissue and this binding could be inhibit ed by GTPγS, supporting the theory that MR is coupled to inhibitory G-proteins system. Conclusion: MR is measured in human embryo tissue, the se results provide experimental data for elucidating the mechanism of the effect of Mel.

Background Human leucocyte antigen (HLA)-B27-associated uveitis is one of the most common causes of non-infectious uveitis.T helper 17 (Th17) cells play an important role in human autoimmune diseases,but the pathology research on the production of Th17 cells in acute anterior uveitis patients positive for HLA-B27 was rarely reported.Objective The aim of this study was to investigate the expression and significance of the peripheral blood T helper cell subsets (Th1,Th2,Th17) in acute anterior uveitis patients positive for HLA-B27.Methods This study meets the criteria of the Helsinki Declaration.Informed consent was obtained from all the participants.A prospective cohort design was used in this study.Twenty-two patients with acute anterior uveitis positive for HLA-B27 were enrolled from Affiliated Second Hospital of Nanjing Medical University,and 16 normal healthy subjects with matched gender and age were enrolled as controls.The expression of interferon-γ (IFN-γ),interleukin-4 (IL-4) and IL-17 on lymphocytes (CD4+) in blood were assessed by flow cytometry,and immunoturbidimetry was used to detect the C reactive protein (CRP) level in blood.The degree of the severity of disease was evaluated by clinical scoring.The correlations between the percentage of IFN-γ+Th1,IL-4+Th2,or IL-17+Th17 with clinical factors and CRP were analyzed.Results The percentages of IFN-γ+Th1 and IL-17+Th17 in the peripheral blood were (23.11 ±9.69) ％ and (3.96±2.92) ％ in the patient group,showing a significant increase in comparison with (16.00±4.26)％ and (1.68±0.60) ％ in the control group (P=0.041,P=0.002).However,the IL-4+Th2 level was not significantly different between the patient group (0.33％ ±0.36％) and the control group (0.56％ ±0.34％) (P=0.122).No significant correlations were found between the percentage of IFN-γ+ Th1 with disease severity and CRP (r =0.197,P =0.500 ; r =0.253,P =0.383),between the percentage of IL-4+ Th2 with disease severity and CRP (r =0.068,P =0.817 ; r =0.439,P =0.116) as well as between the percentage of IL-17 + Th17 with CRP (r =0.226,P =0.436).However,a positive correlation was seen between the percentage of IL-17+ Th17 with disease severity (r =0.805,P =0.001).Conclusions IFN-γ and IL-17 in human CD4+T cells are significantly elevated in the blood of HLA-B27-related acute anterior uveitis patients.Disease severity is associated with the percentage of IL-17 +Th17,suggesting that Th1 cells together with Th17 cells participate in the pathogenesis of the disease and Th17 cells might play a dominant role in the disease.

Objective To analyze the laboratory index characteristics of pulmonary hypertention (PH ) patients with different function states and pressure stages .Methods 2 752 patients diagnosed with PH in the outpatient department ,emergency depart-ment and inpatient department of this hospital from January 2006 to December 2011 were retrospectively analyzed .The clinical as-sessment of the disease condition was done according to the function state and pressure stage of PH recommended by WHO .The characteristics of hematological indexes ,inflammatory indicators and blood gas analysis were observed as well .Results The most common hematological abnormal indexes were the serum brain natriuretic peptide (BNP) elevation(89 .12% ) ,abnormal liver func-tion(58 .32% ) and abnormal hemoglobin(58 .32% ) .The proportion of the PH patients with the elevation of erythrocyte sedimenta-tion rate(ESR) and high-sensitivity C-reactive protein (hs-CRP) were 78 .52% and 73 .59% respectively .The constituent ratio of the BNP increase ,liver function abnormality ,abnormal hemoglobin ,elevation of UA and ESR had statistical differences among the PH patients with different function states and pressure stages (P<0 .05) .The most commonly blood gas analysis abnormality was hypoxemia(83 .08% ) .Respiratory alkalosis had the highest incidence rate in the acid-base imbalance(24 .58% ) .Conclusion The most common hematological abnormal indexes among PH patients are the elevation of serum BNP ,abnormal liver function and he-moglobin abnormality .The laboratory abnormal indexes of above 3 items and the increase of UA and ESR are always related with the severity of disease ,which should to be followed-up .

Objective To discuss how the clinical pharmacists participated in the treatment of pediatric purulent meningi-tis and conducted drug monitoring.Methods Clinical pharmacists involved the whole process of treatment for a purulent men-ingitis infant with renal insufficiency,evaluated medication history,conducted therapeutic drug monitoring and designed an in-dividualized medication treatment plan with clinical physicians.Results Clinical pharmacists assisted clinicians with their phar-macy expertise,and developed individualized drug dosing regimen to achieve effective therapy and medication safety.Conclusion Clinical pharmacists play an important role in providing individualized pharmaceutical care for patients,optimizing the treat-ment plan and improving the rational drug use.

OBJECTIVETo determine the prevalence of depression among cancer patients and its influencing factors.

METHODSWe investigated 7967 cancer patients who lived in communities with cluster sampling based on 'Shanghai Cancer Patient Database'. They were investigated through questionnaires and completed the Zung Self-rating Scale. 6694 questionnaires were identified as 'qualified'. We calculated the prevalence of depression and determined the factors with logistic regression model.

RESULTSThe prevalence rate of depression among cancer patients in communities was 24.74% (95% CI: 23.71% - 25.79%). Results from multi-factor analysis showed that duration since diagnosis, stages at diagnosis, metastasis, therapeutics, KPS scores, and pain VAS scores were the important factors.

CONCLUSIONEarly detection, improving the curative effect and providing community health services could reduce the prevalence of depression.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Depression ; epidemiology ; etiology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; complications ; psychology ; Prevalence ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo observe the effects of Naomaitai capsule on the learning and memory abilities and the content of acetylcholine(Ach) in the brain tissue of the model rat.

METHODOne vascular dementia(VD) model was produced by occlusion of bilateral common carotid arteries in rats with following steps: ischemia 20 minutes-reperfusion 10 minutes-ischemia 20 minutes. The learning and memory abilities were tested by water maze. The other VD model was formed by 4-vessel occlusion-reperfusion injury in rats. The time of right reflect recovery and the content of Ach in the brain tissue were determined.

RESULTNaomaitai capsule can significantly improve the learning and memory abilities of the dementia rats( P < 0.05, P < 0.01), increase the content of Ach (P < 0.05, P < 0.01) and reduce the time of right reflect recovery(P < 0.01).

CONCLUSIONNaomaitai capsule can improve the learning and memory abilities by increasing the content of Ach of the VD rats.

Acetylcholine ; metabolism ; Animals ; Brain Chemistry ; Brain Ischemia ; metabolism ; Capsules ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ginkgo biloba ; chemistry ; Learning ; drug effects ; Male ; Memory ; drug effects ; Neuroprotective Agents ; pharmacology ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; psychology