Objective To evaluate the pathophysiology of paraplegia during transarterial chemoembolization in liver cancer and investigate effective management and prevention for improving clinical situation and relieve major symptoms.Method 2758 patients accepted TACE procedure because of liver cancer(and/or combined with remote metastasis),demonstrated 4 cases suffering from paraplegia(3 males,1 female)since Mar.2003 to Feb.2005,with mean age of(51?14)years old,The operative records and the clinical features after chemoembolization were summarized in detail.Results The incidence of paraplegia was 0.145%,with major symptoms of dysesthesia and hypokinesise emerging within 4 hours after TACE,and most symptoms aggravating gradually within 24-48 hours untill paraplegia appeared,and then turned to stabilization about 5-7 days,with their body functions partial recovery in 2 months.Conclusion More attention should be paied to prevent ectopic embolization of spinal cord vessels originating from extrahepatic collateral arteries during TACE or TAE.

Acute myeloid leukemia (AML) is a genetic heterogeneous disease in which primordial and juvenile myeloid cells proliferate or accumulate abnormally in bone marrow, peripheral blood and other tissues, resulting in damage to normal hematopoietic function. Studies have shown that about 30% of AML patients have FMS-like tyrosine kinase 3 (FLT3), FLT3 abnormal regulation is closely related to the occurrence and development of AML. At present, FLT3 has become an important target for developing small molecular targeted drugs. Currently, a variety of FLT3 inhibitors and FLT3 degraders have been developed targeting FLT3, and some compounds have exhibited good anti-AML activity. This article summarizes and sorts out the current mainstream drugs for AML therapeutic targeting FLT3, in order to provide a reference for the development and design of AML drugs.

Objective:To explorethe the clinical manifestations, treatment and prognosis of anastomotic pseudoaneurysm after renal transplantation caused by infection.Methods:Clinical data of 1 recipient with pseudoaneurysm after renal transplantation due to Pseudomonas aeruginosa infection were retrospectively analysed and combined with a literature review. Results:At Month 2 post-transplantation, the recipient developed right lower abdominal pain, and contrast-enhanced ultrasound examination showed a pseudoaneurysm at the artery anastomosis. Anti-infection and anti-rejection therapy had no obvious effect, and therefore next surgical exploration was performed. A size4.0 cm×3.5cm pseudoaneurysm was found intraoperatively at the graft renal artery anastomosis.After graft was evaluated as having no preservation value, the transplanted kidney and pseudoaneurysm were resected. Bacterial culture indicated Pseudomonas aeruginosa infection.The recipient recovered well and waited for next transplantation. Conclusions:Pseudoaneurysm of transplanted kidney is a very rare complication after renal transplantation, and caused by infection of Pseudomonas aeruginosa is more rarer, It has not been reported in mainland China.This type of recipient has the characteristics of high graft inactivation rate and high mortality rate. Timely surgical resection can effectively prevent the deterioration of disease.

OBJECTIVETo investigate the clinical effect of microsurgical vasoepididymostomy and/or vasovasostomy in the treatment of obstructive azoospermia.

METHODSThis study included 76 patients with obstructive azoospermia, 53 treated by bilateral vasoepididymostomy (8 involving the epididymal head, 18 involving the epididymal body, 5 involving the epididymal tail, and 22 involving the epididymal head, body and tail), 14 by unilateral vasoepididymostomy, and the other 9 by unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis). We followed up the patients for 2 to 16 months for the patency rate, routine semen parameters, and pregnancy outcomes.

RESULTSThe success rate of bilateral vasoepididymostomy, unilateral vasoepididymostomy, and unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis) were 62.26% (33/53), 35.71% (5/14), and 77.78% (7/9), respectively. The average sperm concentrations in the three groups of patients were (27.9 +/- 5.74), (11.8 +/- 8.33), and (19.9 +/- 7.53) x 10(6)/ml, the average total sperm counts were (65.6 +/- 13.71), (28.0 +/- 15.86), and (69.2 +/- 28.59) x 10(6), and the mean rates of progressively motile sperm were (22.3 +/- 3.18), (11.0 +/- 9.77), and (15.8 +/- 5.05)%, respectively. The success rates of bilateral vasoepididymostomy that involved the epididymal head, body, tail, and all the three parts were 62.5, 72.22, 60, and 54.55%, respectively. Natural pregnancy was achieved in 8 (10.53%) of the total number of cases.

CONCLUSIONMicrosurgery is effective for the treatment obstructive azoospermia. Unilateral vasoepididymostomy + unilateral vasovasostomy is superior to the other procedures, followed by bilateral vasoepididymostomy. Bilateral vasoepididymostomy involving the epididymal body may achieve a slightly better effect than that involving the other epididymal parts.

Adult ; Anastomosis, Surgical ; methods ; Azoospermia ; etiology ; surgery ; Epididymis ; surgery ; Female ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery ; Pregnancy ; Pregnancy Rate ; Sperm Count ; Treatment Outcome ; Vas Deferens ; surgery ; Vasovasostomy ; methods

Objective To observe whether the expression of interferon-regulatory factor genes are re- lated to systemic lupus erythematosus (SLE).Methods The clinical data of 45 SLE patients and 37 normal controls were collected.Total RNA of peripheral blood was extracted and transcripted into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression (indicated as-??Ct value) of IRFI,IRF4,IRF8 in patients with SLE and those in the controls.Results The levels of IRF1,IRF4 and IRF8 mRNA were-3.90?0.19,-8.04?0.25 and 3.60?0.15 respectively in normal controls.In SLE patients, IRF4 mRNA expression was -8.82?0.18,higher than that in normal (P=0.011).But IRF8 mRNA expression was 3.09?0.13,lower than that in normal (P=0.012).Conclusion Abnormal IRF mRNA expression is found in the peripheral blood of SLE patients.IRFs may play roles in the pathogenesis of SLE by affecting the differen- tiation of Th cells.

Objectives To clarify the basic data such as prevalent range,regiohal characteristics and the population at risk of drinking brick-tea type fluorosis in China.Methods Comprehensive survey for basic information was conducted in the provinces and autonomous regions where drinking brick-tea type fluorosis Wag prevalent,ineluding Inner Mongolia Autonomous Region,Tibet Autonomous Region, Sichuan Province,Xinjiang Autonomous Region, Qinghai Province,Gansu Province,Ningxia Autonomous Region and Yunan Province.The survey included the number ot counties(cifies)and townships(towns)where the people were accustomed to drinking brick-tea,pepulation,ethnic minority composition,the production and living style,sales and the kinds of brick-tea aIn so on.Results Two hundred and forty-one counties and 3246 townships were found to haye the habit 0f drinking brick-tea,among which 87.46%(2839/3246)had the habit for more than 30 years.There were 31 684 administrative vilages(residents' committees),15 047 elementary schools and 2873 temples surveyed,coveting a total population of 31 052 398 and 122 739 monks.Fifty-three ethnic minorities were involved.Han accounted for 44.86%(12 902 710/31 052 398), Uighur ethnic for 20.98%(7 416 474/31 052 398),Tibetan ethnic for 13.34%(4 323 272/31 052 398),Muslim ethnicfor 8.15%(2 767 603/31 052 398),Mongolian ethnic for 4.61%(1 400 206/31 052 398),Kazak ethnicfor 3.45% (1 218 272/31 052 398),of the population of drinking brick-tea,farmer population accounted for 64.13%(19 912 833/ 31 052 398),herdsman population for 8.79%(2 728 418/31 052 398),farmer-herdsman population for 12.53%(3 889 678/ 31 052 398)and town population for 14.56%(4 521 169/31 052 398).There Was 3926.74 tons of brick-tea sold per year in the investigated regions,mainly of Fu brick-tea,Green brick-tea and Black brick-tea.Areas with high brick- tea consumption distributed mainly in farmer region and farmer-herdsman region.Annual per capita consumption of brick-tea for farmers was 3.77 kg,and for farmer-herdsman population was 2.05 kg.Conclusions Begions with the habit of drinking brick-tea distributes extensively in western China and cover a huge population,and the herdsmen and farmer-herdsman are the main risk population.Drinking brick-tea type fluorosis is a seriolls public health issue in western China.

OBJECTIVETo study the value of basal antral follicle count (AFC) and age in predicting ovarian response and clinical outcome of in vitro fertilization-embryo transfer (IVF-ET).

METHODSA total of 1319 oocyte retrieval cycles in women with an AFC&le;10 and complete IVF/ICSI cycles were analyzed retrospectively. According to the AFC, the patients were divided into groups A, B, and C with AFC&le;4, of 5-7, and of 8-10, respectively, and each was further divided into <38 years old group and ≥38 years old group. The oocytes retrieved, ovarian response, implantation rate, cancellations, pregnancy, pregnancy loss, and live births were evaluated.

RESULTSAs the AFC increased, the total gonadotrophin (Gn) dose increased and the follicles aspirated and oocytes retrieved decreased significantly (P<0.001). Patients below 38 years of age had a lower total Gn dose and more follicles aspirated and oocytes retrieved than older patients. An AFC>7 and age≥38 years was associated with significantly lower total Gn dose, greater number of follicles aspirated and oocytes retrieved, and lower pregnancy rate than an AFC&le;7 and age<38 years (P<0.05). Bivariate correlation and linear regression analysis identified AFC as the best single predictor of ovarian response in IVF. The pregnancy rate differed significantly between the 3 groups, and older patients (≥38 years) had higher early miscarriage rate.

CONCLUSIONAntral follicle count&le;7 or age≥38 years old with AFC&le;10 is the suitable threshold of diminished ovarian reserve in controlled ovarian stimulation for infertile women. Combination of AFC and age is the best predictor of ovarian response in IVF. Age has a better predictive value of pregnancy rate than AFC. AFC influences mainly the oocytes quantity, while age also affects oocyte quality.

Adult ; Age Factors ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Ovarian Follicle ; anatomy & histology ; cytology ; physiology ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

OBJECTIVETo evaluate the effect of elevated basal follicle-stimulating hormone (FSH) on both the quantity and quality of oocytes and embryos and the clinical outcomes of pregnancy in women under 35 years of age.

METHODSA retrospective analysis was conducted for inspecting 294 in vitro fertilization-embryo transfer (IVF-ET) cycles in women under 35 years of age. According to the basal FSH levels, the women were divided into groups A, B, and C with basal FSH of 10-14.99, 15-19.99 and ≥20 IU/L, respectively, to compare the average number of oocytes retrieved, morphologies of the oocytes and embryos, and clinical outcomes of pregnancy.

RESULTSGroup A showed greater average numbers of oocytes collected, total embryos and good-quality embryos with a lower gonadotrophin dose required to achieve follicular maturity than groups B and C. The 3 groups showed no significant differences in the percentage of metaphase II oocytes, optimal embryos-blastomere number, normal fertilization rate, cleavage rate, good-quality embryo rate, implantation rate, pregnancy rates, live birth rate or miscarriage rate, but the pregnancy rates and live birth rate tended to decrease in women with basal FSH ≥15 U/L.

CONCLUSIONIn women below 35 years of age, an elevated serum FSH (especially one ≥15 U/L) indicates diminished ovarian reserve and reduced numbers of oocyte and embryo but not poor oocyte or embryos quality, and good clinical pregnancy rate can still be expected.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Female ; blood ; therapy ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Young Adult

OBJECTIVETo detect the velocity and viscosity of blood flow of the vertebral arteries, the apoptotic cell and apoptotic related protein in the brain in order to offer theoretical foundation for the treatment of cervical spondylopathy of the vertebral artery type with the eliminat dampness resolv phlegm method.

METHODSSixty male Japanese big ear rabbits were divided randomly into normal sodium group (A), Flunarizine group (B), low dosage Wendantang group (C), large dosage Wendantang group (D), Flunarizine group combined with large dosage Wendantang group (E), normal group (F). Each group had 10 rabbits. Xiaozhiling injection was injected around the vertebral arteries of rabbits in group A, B C, D, E to make the model of the cervical spondylopathy of the vertebral artery type. Normal sodium (20 ml x kg(-1)d(-1)) was apply through intragastric administration in group A, F; Flunarizine (0.8 mg x kg(-1)d(-1)), low dosage Wendantang (1 g x ml(-1)d(-1)), large dosage Wendantang (2 g x ml(-1)d(-1)), Flunarizine combined with large dosage Wendantang were respectively apply through intragastric administration in group B, C, D, E. The velocity and viscosity of blood flow of the vertebral arteries, the apoptotic cell and apoptotic protein in the brain were detected before and after the treatment.

RESULTSSatisfactory animal model were obtained in group A, B, C, D, E. The rabbits of group E had the most improvement of the velocity and viscosity of blood flow of the vertebral arteries while at meantime, which had the lowest apoptotic index and apoptotic related protein expression in the brain.

CONCLUSIONThe routine treatment for the cervical spondylopathy of the vertebral artery combined with eliminat dampness resolv phlegm method could improve velocity and viscosity of blood flow of the vertebral arteries, which maybe relate with reduction of apoptosis in the brain.

Animals ; Blood Flow Velocity ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Rabbits ; Random Allocation ; Spondylosis ; drug therapy ; physiopathology ; Vertebral Artery ; drug effects ; physiopathology

OBJECTIVETo explore the functional brain localization with magnetic resonance imaging (MRI) after acupuncturing the Yuan-Source and He-Sea acupoints of Stomach Meridian of Foot-Yangming (ST).

METHODSThe study was performed in 30 healthy volunteers who underwent acupuncture at Yuan-Source acupoint (Chongyang, ST42) and He-Sea acupoint (Zusanli, ST36) (ST group). Ten of these were also underwent acupuncture at the non-acupoints as the control group. Blood oxygenation level dependent functional MRI was performed.

RESULTSIn the ST group, signal increasing areas were demonstrated in bilateral superior temporal gyri (Broadmann 22), bilateral supramarginal gyri (Broadmann 40), bilateral cerebellar hemispheres, bilateral cingulate gyri and isthmus of cingulate gyri (Broadmann 32, 30), bilateral superior parietal lobules (Broadmann 7); signal decreasing areas were shown in bilateral orbital gyri (Broadmann 11), bilateral temporal pole (Broadmann 38), right inferior frontal gyrus (Broadmann 47) and right medial occipitotemporal gyrus (Broadmann 36). In the control group, signal increases areas were demonstrated in superior temporal gyri, precentral gyri, cingulate gyri, thalamus, insula and cerebellum. The size, signal intensity and number of increasing areas in control group are less than in ST group.

CONCLUSIONCombined acupuncture of Yuan-Source and He-Sea acupoints of ST can activate and decrease the multiple brain regions of "splanchnic brain" and thus reach a new functional balance to relieve pain.

Acupuncture Points ; Adult ; Brain ; physiology ; Electroacupuncture ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Meridians ; Young Adult