Objective To investigate the early clinical effects of percutaneous kyphoplasty in the treatment of age-related osteo-porotic vertebral compression fractures .Methods Retrospected 54 cases with osteoporotic verebral compression fractures were treated with PKP ,summarized early clinical effects and complications .analysis of preoperative and postoperative wound vertebral height average recovery rate ,Cobb Angle ,VAS scores and ADL scores .Results Operations in all the 54 cases were completed smoothly ,47 cases for 6 to 24 months follow-up(mean 13 .5 months) .postoperative pain in 31patients obtained remission immedi-ately ,1 week after operation ,12 cases with lower back pain and need the non-steroidal anti-inflammatory medications ,the symptoms remissed significantly or disappeared after 8 weeks postoperatively .At the last follow-up ,4 patients still had low back pain and need oral analgesics .Preoperative and postoperative wound vertebral height average recovery rate ,Cobb Angle ,VAS scores and ADL scores was statistically significant .Conclusion PKP is a minimally invasive ,effective and safe procedure that provides pain relief and stabilization of spinal stability and activities under the bed early ,and improves quality of life at the same time .Grasping the indi-cations Strictly and holding the surgical skills can be obtained clinical results efficiently and safely .

OBJECTIVETo investigate the effect of T-cell vaccination in murine experimental autoimmune hepatitis (EAH).

METHODSTo induce the EAH model, the syngeneic S-100 antigen emulsified in complete Freud's adjuvant was injected intraperitoneally to C57Bl/6 at day 1 and day 7. For T-cell vaccination, splenocytes were removed from animal 2 weeks after induction of EAH and from control animals, and activated in vitro by mitogen stimulation with Concanavalin A (Con A), then inactivated by mitomycin and injected at 5 10(7) cells per animal as T-cell vaccination at 14 and 7 days before first induction of EAH.

RESULTSThe histological grade and serum ALT level of the mice who received T-cell vaccination were decrease significantly, compared with that of model group (1.44+/-0.88 vs. 2.33+/-0.87, t=2.24, P<0.05; 63.0U/L+/-23.4U/L vs. 115.0U/L1+/-39.6U/L, t=2.37, P<0.01, respectively); there was no significant change in mice who received irrelevant T-cell vaccination.

CONCLUSIONT-cell vaccination with T cells from EAH animals, but not with irrelevant T cells, was able to protect animals from EAH.

Animals ; Hepatitis, Autoimmune ; prevention & control ; Male ; Mice ; Mice, Inbred C57BL ; T-Lymphocytes ; immunology ; Vaccination

OBJECTIVETo study the clinical characteristics, diagnosis, treatment and prognostic factors of gastrointestinal stromal tumor(GIST).

METHODSClinicopathological data of 217 GIST patients from January 2005 to September 2010 in Wuhan Union Hospital were analyzed retrospectively and the prognostic factors were evaluated.

RESULTSThere were 103 males and 114 females with a median age of 55 years old. Two hundred and thirteen patients underwent R0 resection and 4 R1 resection due to extensive invasion. Thirty-five patients underwent laparoscopic resection. Forty-eight patients received imatinib mesylate therapy after surgery. A total of 178 patients(82.0%) were followed up for 3 to 74 months. Sixteen patients(9.0%) developed recurrence or metastasis. Logistic regression analysis showed that tumor location (OR=2.547, 95% CI:1.466-4.424) and mitotic count(OR=6.556, 95% CI:2.974-14.449) were independent factors for post-operative recurrence or metastasis. Five patients survived with tumor, and 11 patients(6.2%) died of GIST including intestinal GIST(n=7) and extraintestinal GIST(n=4). Cox regression analysis showed that the mitotic count (RR=2.654, 95% CI:1.094-6.438) and post-operative recurrence or metastasis (RR=32.988, 95% CI:3.879-280.529) were independent prognostic factors.

CONCLUSIONSTumor location and mitotic count are independent risk factors for post-operative recurrence or metastasis in GIST. Mitotic count and post-operative recurrence or metastasis are independent indicators of poor prognosis. Surgical radical resection combined with targeted therapy can achieve satisfactory outcomes in patients with GIST.

Adult ; Aged ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo study the distribution of aldehyde dehydrogenase-2 (ALDH2) polymorphisms between healthy Zhuang and Han ethnic individuals in Guangxi Autonomous Region and its influence to the behaviors of alcohol consumption.

METHODSPolymerase chain reaction with confronting two-pair primers (PCR-CTPP) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques were used to genotype ALDH2, respectively, and alcohol consumption was recorded in a constructed questionnaire.

RESULTSThe frequencies of ALDH2 alleles (ALDH2(1)/ALDH2(2)) among Zhuang and Han ethnics were 0.511, 0.489 and 0.508, 0.492 respectively (chi2 = 0.001, P > 0.05). The ALDH2 genotypes were verified with PCR-RFLP method. The frequencies of ALDH2(1) genotype in alcoholics (> or = 3 times drinking per week) were 35.59% and 15.67% in Zhuang and Han groups respectively (chi2 = 5.800, P = 0.016).

CONCLUSIONThere was no significant different distribution of ALDH2 genotype among healthy Zhuang and Han ethnic people. The genotype of ALDH2 in different ethnicity might influence individual behavior of alcohol consumption.

Adult ; Aldehyde Dehydrogenase ; genetics ; Aldehyde Dehydrogenase, Mitochondrial ; Alleles ; China ; DNA Primers ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length

OBJECTIVETo assess the value of multiplex PCR-denaturing high-performance liquid chromatography (PCR-DHPLC) method for screening large duplications or deletions in patients with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA).

METHODSDNA was extracted from peripheral venous blood samples from 35 DMD and 6 SMA patients. Large duplications or deletions were screened with multiplex PCR coupled with DHPLC method. The results were validated with testing of positive and negative controls.

RESULTSKnown duplications or deletions in all controls were reliably detected with multiple PCR coupled with DHPLC. Large duplications or deletions were found in 71.4% of 35 DMD patients, which included 5 large duplications and 20 large deletions. For SMA patients, deletions of SMN1 exon 7 were detected in 16 samples.

CONCLUSIONMultiplex PCR coupled with DHPLC method is an effective and reliable method for detecting large genomic duplications or deletions in patients with DMD or SMA.

Chromatography, High Pressure Liquid ; Dystrophin ; genetics ; Gene Deletion ; Gene Duplication ; Humans ; Multiplex Polymerase Chain Reaction ; Muscular Atrophy, Spinal ; diagnosis ; genetics ; Muscular Dystrophy, Duchenne ; diagnosis ; genetics ; Survival of Motor Neuron 1 Protein ; genetics

OBJECTIVETo investigate the clinicopathological features, diagnosis, treatment and prognosis of primary clear cell carcinoma of the liver (PCCCL).

METHODSThe clinicopathological data of 24 cases with pathologically proven PCCCL in the First Affiliated Hospital of Guangxi Medical University from May 1996 to December 2003 were collected and analyzed.

RESULTSThere were 21 males and 3 females in this group, with an average age of 46 years (range: 30 approximately 78 years). HBV infection was detected in 83.3%, and AFP expression was found in 75.0% of them. Of the 24 cases, 28 tumors were found with an average size of (6.64 +/- 5.54) cm. Liver cirrhosis was found in 75.0% of the patients. Macroscopic and microscopic tumor thrombi were found in 20.8% and 29.2%, respectively. Lymph node metastasis was found in 4.2% of the patents. The 1-, 3-, and 5-year overall survival rates of the 24 cases were 75.0%, 41.7% and 27.8%, respectively, with a median survival time of 29 months.

CONCLUSIONThe clinical characteristics of primary clear cell carcinoma of the liver are similar to that of common hepatocellular carcinoma. It is difficult to be diagnosed preoperatively and final diagnosis depends on pathological examination. Surgical resection is an effective way to achieve favorable treatment outcome and even long-term survival.

Adenocarcinoma, Clear Cell ; blood ; pathology ; surgery ; virology ; Adult ; Aged ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Hepatitis B ; Humans ; Liver Neoplasms ; blood ; pathology ; surgery ; virology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate ; alpha-Fetoproteins ; analysis

OBJECTIVEIn order to provide a reliable basis for the diagnosis and treatment of autoimmune hepatitis (AIH) and its overlap syndrome, we investigated the clinical, immunological characteristics of and the therapeutic methods for AIH and AIH-primary biliary cirrhosis (PBC) overlap syndrome.

METHODSOne hundred seven patients (77 with AIH and 30 with AIH-PBC overlap syndrome) were enrolled in the study. Their clinical manifestations, serum liver function tests (LFTs) findings, serum immunoglobulins, liver histopathological changes and their responsiveness to the therapies were investigated.

RESULTSThe age distribution of AIH patients showed a single peak during their fifties and their main clinical manifestations were malaise, abdominal distension, anorexia and jaundice. Serum gamma globulin and IgG were significantly higher than their normal levels. 74% of the patients were positive for anti-nuclear antibody (ANA), 32% of the patients were positive for anti-smooth muscle antibody (AMA), and over 50% of the patients suffered from concurrent extrahepatic autoimmune diseases. The main histological changes in the liver biopsies were interface hepatitis (65%), lobular hepatitis and rosette formation of liver cells. Bridging necrosis was observed in severe AIH cases. In the AIH-PBC overlap syndrome patients, the levels of serum ALT, AST, GGT, ALP and incidences of ANA and AMA/AMA-M2 were all significantly higher than those of the AIH group. After treating AIH patients with prednisolone and azathioprine (Aza), complete response was seen in 42 cases (70%), sustained response was seen in 26 cases (43%). Sixteen cases had relapses after the withdrawal of the treatment or prednisolone dosage was reduced lower than 10 mg/d. The cases having normal serum ALT, AST, gamma-globulin and IgG levels after treatment were still responding to the reduced prednisolone dosage of 5-10 mg/d without azathioprine added. After combination with ursodeoxycholic acid (UDCA) treatment, the liver function tests (AST, ALT, TBil) of AIH-PBC overlap syndrome patients also significantly improved compared to those before the treatment (P<0.01).

CONCLUSIONAIH and AIH-PBC overlap syndrome are not rare in our clinics. Their diagnoses should be based on the clinical presentations, biochemical and immunological indices and liver histological changes. In AIH cases, once their AST, ALT, gamma-globulin and IgG levels return to normal, the prednisolone dosage can be maintained at 5-10 mg/d and Aza can even be withdrawn. Good improvement for patients with AIH-PBC overlap syndrome can be obtained with UDCA and immunosuppression treatment.

Female ; Hepatitis, Autoimmune ; diagnosis ; drug therapy ; Humans ; Liver Cirrhosis, Biliary ; diagnosis ; drug therapy ; Male ; Middle Aged ; Prognosis ; Syndrome

Objective To evaluate the impact of different rating instruments used by raters with different seniority in OSCEs. Methods Surgical interns were randomly divided into two groups to undertake a nine－station surgical OSCEs. Raters with different seniority were also divided into two groups with four senior raters and four junior raters in one group. OSCE results were compared. Results There was no statistical significance when comparing results from different raters using checklist rating instrument. Results from different raters using global rating scale instrument were significantly different. Correlations between raters using checklist and global rating scale instruments showed statistical significance in 81.3% of stations. Conclusion Checklist rating instrument showed high capability of repeating the results. Therefore, it is recommended to apply checklist as many as possible in OSCE exams with mixed rater seniorities. Research on design of rating instruments are to be investigated to insure the effectiveness as well as the credibility of the rating system.

Due to the lack of typical symptoms and imaging findings, gastric gastrointestinal stromal tumor (GIST) is easy to be misdiagnosed as other gastric tumors clinically. In clinical practice, clinicians should adopt the multidisciplinary team model, fully understand the characteristics of gastric GIST, grasp the key points of its differential diagnosis from other gastric tumors to achieve precise diagnosis and treatment. This paper analyzes the causes of misdiagnosis and elucidates the differential diagnosis of gastric GIST, aiming to improve the accuracy of preoperative diagnosis, reduce the misdiagnosis, and improve treatment outcomes.
Diagnosis, Differential ; Diagnostic Errors ; Gastrointestinal Stromal Tumors/diagnosis* ; Humans ; Stomach Neoplasms/diagnosis* ; Treatment Outcome

OBJECTIVETo explore the value of CT perfusion in early diagnosis and management of superacute local cerebral infarction in rhesus monkeys.

METHODAcute local cerebral infarction was induced in the rhesus monkeys during digital subtraction angiography (DSA) by introduction of pale thrombus prepared from autologous blood into the M1 branch of the middle cerebral artery (MCA). Plain CT scan and CT perfusion scanning were performed at different time points before and after DSA operation, and the results were analyzed in conjunction with the pathologic changes.

RESULTSIschemic lesions were displayed on CT perfusion images, which showed local hypoperfusion, reduced cerebral blood flow and volume, and mean transit time delay in the compromised area. Local hypointense infarct area was identified in plain CT scan 24 h after the DSA operation, and the results were in good agreement with pathological examination during autopsy.

CONCLUSIONCT perfusion imaging of the brain can accurately capture the cerebral perfusion deficits in acute ischemic stroke before morphologic changes take place, and therefore provides good means for thrombolytic treatment evaluation of stroke.

Acute Disease ; Animals ; Brain ; diagnostic imaging ; Brain Ischemia ; diagnosis ; Cerebral Infarction ; diagnosis ; Contrast Media ; administration & dosage ; Early Diagnosis ; Macaca mulatta ; Perfusion ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods