BACKGROUND: Nowadays, it is reported that vessel structural abnormity is the main morphological basis of vertigo due to vertebrobasilar arterial insufficiency abroad, but the report of vascular structural abnormality in vertebrobasilar arterial insufficiency is rare at home.OBJECTIVE: To observe the manifestation and clinical significance of vessel structural abnormity tested by digital substraction angiography (DSA)in patients with vertigo induced by vertebrobasilar arterial insufficiency.DESIGN: Case analysis.SETTING: Department of Neurology, Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University and Department of Neurology, Huaihua Hospital Affiliated to Nanhua University.PARTICIPANTS: A total of 57 patients, who were diagnosed as having episodic vertigo with or without nausea or vomiting, and hospitalized in the Department of Neurology, Huaihua Hospital Affiliated to Nanhua University from August 2003 to May 2004 and Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University between October 2004 and May 2005, were enrolled.METHODS: Fifty-seven patients with vertigo induced by vertebrobasilar arterial insufficiency hospitalized in the recent two years were treated with digital subtraction radiography in aortic arch and aortocranial angiography:Applying retrograde angiography of femoral artery puncture, Optiray nonionic contrast agent with syringe pattern to perform aortic arch angiography. Digital subtraction machine displayed bilateral carotid artery, vertebral artery, ranged from carotid artery to siphon of carotid artery from multiple angles. Measurement and evaluation were conducted by 2 doctors from department of neurology.MAIN OUTCOME MEASURES: Type, distribution and proportion of vesselstructural abnormity of aortic arch, carotid artery and vertebrobasilar system.RESULTS: Of the 57 patients, 1 patient was dropped out, because the left vertebral artery (LVA) could not be entered. A large area cerebral infarction was occurred in another patients during aortic arch angiography was performed, and the operation was stopped. Totally 55 patients were involved in the result analysis. It was found that 71%(39/55) of patients had vessel structural abnormity in cervical part and intracalvarium, 11%(6/55)of patients with simple anterior circulation lesion, 60% (33/55) of patients with posterior circulation lesion, of which 9 cases (16%) with compound lesion of anterior circulation abnormity. Two or above vessels in 24 cases (24/55,44%) were involved. Vertebral artery complicated with other angiostegnosis was the most common, and there was no vessel structural abnormity in other 16 cases (16/55,29%).CONCLUSION: Various types of vessel structural abnormity are the main etiological factors of vertigo induced by vertebrobasilar arterial insufficiency. Gold standard of diagnosing vertigo due to vertebrobasilar arterial insufficiency is DSA.

Asian Continental Ancestry Group ; Head ; surgery ; Humans ; Neck ; surgery ; Otolaryngology

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (Mtb), is still one of the significant threats to human life. In recent years, the continuous exploration of small molecule inhibitors represented by bedaquinoline has brought new vitality into the field of tuberculosis. However, small molecule inhibitors will inevitably occur acquired drug resistance during clinical medication. As a new pharmacological mechanism, targeted protein degradation (TPD) achieves efficacy by destroying rather than inhibiting protein targets. It might be an excellent strategy to develop anti-tuberculosis drugs based on the TPD concept to solve drug resistance. This article reviews the protein degradation pathways of Mtb, such as the Pup proteasome system and the ClpP-ClpC1 complex enzyme system. The future development of these strategies into TPD drugs was prospected and summarized.

Adult ; Aged ; Dermis ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; pathology ; Reconstructive Surgical Procedures ; methods ; Wound Healing

Objective To investigate the acute toxicity, subacute toxicity, nasal membrane local toxicity of the Magnolia biondii Pamp volatile oil nanometer bangosome. Methods Kunming mice and SD rats were selected as experimental material. Kunming mice were used in the acute and subacute toxicity tests by intragastric administration of Magnolia biondii Pamp volatile oil nanometer bangosome with different dosage and different time, and SD rats were used in the nasal membrane local toxicity test by nose dropping, while the control group was treated with intragastric administration of or nose dropping with normal saline for the same dosage. The treatment course lasted fifteen days. At the end of the tests, the general condition, routine blood test, function index of live and kidney, organ humid weight index, histological changes of liver and kidney and ultra microstructure change of rat nasal membrane were obtained and compared with the control group. Results In the acute toxicity test, the daily maximum tolerant dosage by intragastric administration was equal to 222.7 times of the clinical routine, with no marked toxic reaction. In the subacute toxicity test, the general condition, blood test, organ humid weight index and histological changes of live and kidney in different dosage groups were similar to the control group. While in the function index of live and kidney, uric acid was stepped down in the middle and large dose groups, and total bilirubin was decreased in the large dose group. The nasal membrane local toxicity test revealed that there was little change in the ultra microstructure of rat nasal membrane.Conclusion The Magnolia biondii Pamp volatile oil nanometer bangosome may have little toxicity by intragastric administration and nose dropping.

Objective To explore the relationship between administration of different doses of colloid before general anesthesia induction and general anesthesia-induced hypotension. Methods Fifty patients for selective gastrointestinal operations were randomly divided into 5 groups according to the volume of colloid administered 30 min before general anesthesia induction: 0 mL/kg group (control group), 4 mL/kg group, 8 mL/kg group, 12 mL/kg group and 15 mL/kg group. To replace the deficit of hypovolemia before operation, crystalloid was given to each patient. Anesthesia was induced with propofol 25 min after infusion. Hemodynamic parameters were compared before and after anesthesia induction among groups. Results The changes in diastolic blood pressure and mean arterial blood pressure were related to colloid supplementation volume (r=-0.657, P<0.01). There were significant differences between control group and 8 mL/kg group, 12 mL/kg group and 15 mL/kg group (P<0.05), while there was no significant difference among 8 mL/kg group, 12 mL/kg group and 15 mL/kg group. Conclusion Administration of colloid before general anesthesia induction attenuates the severity of general anesthesia-induced hypotension, especially when the dose of colloid is over 8 mL/kg.

Objective To understand the current status of advanced schistosomiasis in Pukou District,Nanjing City,so as to provide the evidence for its appropriate treatment. Method An epidemiological investigation and medical examinations were carried out based on the national standard for the people who either had been already identified as advanced schistosomiasis or were new suspects. Results There were 55 cases of advanced schistosomiasis in Pukou District,2013. Among them,51 cases (92.73%)were splenomegaly type and 4 cases(7.27%)were ascites type. Fifty-three cases(96.36%)were clinically cured,1 case(1.82%)was in the stable condition and 1 case(1.82%)still needed further treatment. In terms of the age,the youngest was 49 years and the oldest was 86 years. The gender distribution was male accounting for 58.18%(32 cases)and female 41.82%(23 cases). Conclusion The condition of patients with advanced schistosomiasis in Pukou District,Nanjing City is complicated. The investigation and treatment to the patients should be conducted regularly.

OBJECTIVE To discuss the possibility of HBV contaminating environment and transmission through the polluted surroundings. METHODS On the basis of that ascertain the contaminated environment by HBV marker(HBVM) and the relationship between HBVM and HBV infectivity in the blood,to discuss the probability of HBV contaminating and be spreading through the circumstance. RESULTS The positive rate of HBsAg and HBeAg was 26.39% and 11.11%,respectively in these specimens.While all of samples in control group were negative.The HBV DNA positive rate was 73.72% and 100.00%,respectively in the positive blood specimens of HBsAg and HBeAg.The infectivity was 0-10~9 and 10~2-10~9 ID/ml,respectively. CONCLUSIONS The blood worktable surface is contaminated by HBVM.The pollution is from patients′ blood.So the probability exists that HBV is transmitted through environment pollution.

OBJECTIVE To get knowledge of the drugs resistance change of Pseudomonas aeruginosa in intensive care unit (ICU) from 2001 to 2006, so as to offer the first-hand information to the clinical preventive and therapeutic countermeasures. METHODS The P. aeruginosa antimicrobial susceptibility tests to 15 commonly used antibiotics were performed from 2001 to 2006. RESULTS The most frequent isolates were P. aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii in 2001-2004. Staphylococcus aureus was more than A. baumannii in 2006, and became the major isolated pathogen in the sputum of the ICU patients. The multi-resistant P. aeruginosa increased yearly, and drugs susceptibility to carbapenem had decreased sharply in the past 6 years. CONCLUSIONS It was showed that P. aeruginosa is the major pathogen in the ICU, and the pathogens show the high drug resistance. Doctors should pay more attention to analyze the bacterial resistance profile in order to decrease the incidence of drug resistance and use the antibiotics properly.

Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.