Adult ; Aged ; Axilla ; innervation ; surgery ; Brachial Plexus ; surgery ; Breast Neoplasms ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Mastectomy, Radical ; adverse effects ; methods ; Middle Aged ; Pain, Postoperative ; etiology ; Somatosensory Disorders ; etiology

BACKGROUND:Topping-off technique can be used for fixation treatment through the combination of fusion and interspinous dynamic device, in order to prevent or slow down the adjacent lumbar segment degeneration.
OBJECTIVE:To obverse the protective effect of Topping-off technique (posterior lumbar interbody fusion
procedure combined with the fixation of dynamic interspinous device Coflex) for the degenerative intervertebral disc. METHODS:A total of 32 patients with degenerative lumbar diseases who had been treated with Topping-off technique were included in this study. The Oswestry disability index, the Japanese Orthopaedic Association scores, range of motion for Coflex implanted segment and during the relative signal intensity of the Coflex implanted segment in MRI image were recorded and calculated preoperatively and the entire fol ow-up period.
RESULTS AND CONCLUSION:Al patients were fol owed-up for 20.6 months averagely. Up to the last fol ow-up, the Oswestry disability index and Japanese Orthopaedic Association scores were significantly improved when compared with those before treatment (P<0.001). There was no significant difference in the range of motion for Coflex implanted segment before and after treatment (P=0.19). The relative signal intensity of the Coflex implanted segment was significantly improved when compared with that before treatment (P<0.01). The clinical application of the Topping-off technique showed a protective effect on the intervertebral disc.

Objective To compare the iodine intake,image quality and radiation dose of dual-source CT coronary artery angiography between the low concentration isotonic contrast agent with iterative reconstruction technique of sinogram affirmed iterative rEconstruction (SAFIRE) and common concentration contrast agent with filtered back projection (FBP).Methods One hundred patients [58 men,42 women; age:(62± 11)y] were enrolled in this study.Fifty consecutive patients (Group A) were scanned with FBP and common concentration contrast agent and another 50 consecutive patients (Group B) were scanned with low concentration isotonic contrast agent and iterative reconstruction technique.The image quality were assessed by two experienced radiologists with a double blinded fashion in a five score scale.The attenuation of coronary artery,scan time,imaging noise,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),radiation dose and iodine intake between these two groups were compared using two sample t test.The observer agreement for image quality was calculated using Kappa statistics.Results All examinations were completed successfully.There was no statistical difference (P＞0.05) between two groups in clinical characteristics and scan parameters.There was no statistical difference for the mean subjective image quality of group A (4.4±0.7) and group B (4.3±0.8) (t=0.924,P＞0.05).The Kappa value between two radiologists was 0.887 (P＜0.01)on image quality.The mean attenuation of coronary artery segments was higher than 300 HU,especially in group A (386.1±51.5) HU,which was slightly higher than the group B (384.1±77.1) HU,but there was no statistical difference (t=0.157,P＞0.05).The SNR and CNR in two groups did not have significant differences (P＞0.05).The total iodine and iodine injection rates were 21.0 g,17.5 g/s in Group A and 16.2 g,13.5 g/s in Group B,respectively.The iodine intake was decreased by 22.9％ in Group B.The effective radiation dose in Group B (1.09±0.19) mSv was significantly (t=20.260,P＜0.01) lower than that in Group A (2.85±0.59) mSv,with the radiation dose reduced by 61.8％.Conclusion Low concentration isotonic contrast agent and iterative reconstruction technique can significantly reduce the radiation dose and iodine intake in CT coronary artery angiography and achieve the same image quality using common concentration contrast agent with FBP.

Antigen Rv2628 of Mycobacterium tuberculosis is associated with latent tuberculosis infection. In this study, Rv2628 was prokaryotic expressed and purified, its immunological characteristics was evaluated with macrophage cell line RAW264.7 and BALB/c mice. The results show that Rv2628 was mainly expressed in form of inclusion body confirmed by SDS-PAGE, and could react with rabbit anti-H37Rv polyclonal antibody detected by Western blotting assay, indicating that the protein had an effective immunoreactivity. The interactions between Rv2628 and macrophage cell line RAW264.7 confirmed that it could effectively induce cells to produce pro-inflammatory cytokines, the relative expression level of IL-6 mRNA was higher than the control group in 1-12 h. BALB/c mice were subcutaneously immunized with Rv2628 protein, the production of IFN-gamma and IL-4 in the spleen cells was determined by Sandwich ELISA, in the Rv2628 immunized group, the level of IFN-gamma was significantly higher than that of IL-4 (P < 0.000 1). It indicated the protein induced Th1-tendency immune responses. At the same time, Rv2628(11-30) peptide used as coating antigen, the murine serum antibody titer detected by indirect-ELISA was 1:1 600, which demonstrated that Rv2628 could also induce humoral immune responses. In summary, Rv2628 could induce specific pro-inflammatory cytokines, affectively induce strongly Th1-tendency immune response and humoral response, it could be a potential target for developing subunit vaccine against TB. In addition, it laid foundation for probing the cross-talk between M. tb and host.
Animals ; Antibodies, Bacterial ; blood ; Antigens, Bacterial ; immunology ; Cell Line ; Electrophoresis, Polyacrylamide Gel ; Interferon-gamma ; immunology ; Interleukin-4 ; immunology ; Interleukin-6 ; immunology ; Macrophages ; immunology ; Mice ; Mice, Inbred BALB C ; Mycobacterium tuberculosis ; Th1 Cells ; immunology ; Tuberculosis ; immunology

Objective: To investigate the impairment status of vestibular and limb peripheral nerve of patients with auditory neuropathy, improve the understanding of auditory neuropathy in general. Method: Vestibular function tests and nerve conduction velocity (NCV) examinatoin were performed on 28 young patients with auditory neuropathy which confirmed by clinical auditory tests diagnosis from March 1999 to November 2000. There were 14 males and 14 females, ranging in age from 22 to 28 years old. Results: Vestibular dysfunction was encountered in 22 of 28 (78.57%) suffering from auditory neuropathy. Limb peripheral nerve impairment was found in 11 of 28 patients (39.29%) of auditory neuropathy. The caloric responses were normal symmetric responses in 6 of 28 (21.43%,6/28), and weaken bilaterally in 20 of 28 (71.43%,20/28)respectively. On the NCV examination, both motor conduction velocity (MVC) and sensory conduction velocity (SCV) were normal in 17 (60.71%,17/28), abnormal in 4 (14.29%,4/28). Four cases showed abnormal MCV and SCV. And pure MCV abnormality and pure SCV abnormality were found on 4 and 3 cases respectively. Conclusion: The pathological process affecting the auditory nerve may also affect the vestibular nerve and other peripheral nerve. This seemed possible in view of fact that auditory neuropathy may affect one nerve (mononeuropathy) or multiple nerves (polyneuropathy).

Objective To explore the relationship of different body mass index, waist circumference and serum lipid levels with essential hypertension among residents of Ningbo. And to explore the predictive value of BMI and WC (Waist Cir-cumference) for hypertension. Methods Adopting cluster sampling, 2 303 people (1 081 cases of hypertension and 1 222 people with normal blood pressure) were collected in the four townships of Ningbo City. We conducted questionnaires, physi-cal examination and blood lipid testing for all of subjects. WC group:WC≥85 cm in male or WC≥80 cm in female is central obesity, and the others are normal. BMI groups:BMI≥24 kg/m2 is overweight, and BMI<24 kg/m2 is normal. The relationship of BMI, WC and serum lipid levels with hypertension was analyzed by multivariate unconditional logistic regression model. The predictive value of BMI and WC for hypertension was analyzed by receiver operating characteristic (ROC) curve. Results WC, BMI, total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in hypertension group were higher than those in control group (P<0.01). And WC, BMI, TG, LDL-C is the impact factor for hypertension. The overweight rate and central obesity rate in hypertension group were higher than control group (P<0.01). TG and LDL-C level abnormality, overweight and central obesity were the risk factors of hypertension. As a risk factor of hypertension, over-weight with central obesity group is higher than overweight with normal waistline group, simple central obesity group and nor-mal group. In the area under the ROC curve, BMI is higher than WC in both male and female population. Conclusion WC, BMI, TG and LDL-C abnormalities were risk factors for hypertension, and BMI was a better predictive factor for hyper-tension than WC.

Objective To explore the relating factors for cognitive dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Totally 150 patients with acute exacerbation of COPD (AECOPD) and 150 gender and age-matched healthy subjects (controls) received the cognitive and depression function assessment.150 AECOPD cases were classified into two groups:COPD patients with or without cognitive dysfunction.Fasting blood uric acid (UA) was measured and compared between the two groups.Relating factors for cognition dysfunction were analyzed.Results The score of Montreal Cognitive Assessment (MoCA) was reduced in AECOPD patients as compared with controls [(19.01±3.58) vs.(26.58±1.42)scores,t=-3.48,P=0.032].The score of Hamilton depression (HAMD) scale was higher in AECOPD patients than in controls [(18.05 ± 4.50) vs.(9.98 ± 3.51) scores,t =4.63,P =0.028].The prevalence of cognitive impairment in the patients with AECOPD was 82 cases (54.7％).The serum UA level was lower in the AECOPD patients with cognitive impairment than in patients without cognitive impairment [(235±42) μmol/L (n=82) vs.(332±45) μmol/L (n=68),t=-6.65,P=0.003].In AECOPD patients,the cognitive function was correlated with education,length of hospital stay,serum UA level,COPD stages,disease duration and the depression level,but was not correlated with smoking and body mass index.Conclusions The cognitive impairment is highly prevalent in patients with AECOPD,which is associated with lower serum UA level,longer hospital stay and disease severity.

Objective: To observe the effect of different moxibustion durations on rats with rheumatoid arthritis (RA) and to evaluate the relationship between moxibustion amount and moxibustion efficacy.Methods: Eight rats were randomly selected as a normal group from the 40 male Sprague-Dawley (SD) rats, and the other 32 rats were used to establish typeⅡ collagen-induced RA models. After successful modeling, the 32 rats were randomly divided into a model group, a moxibustion for 20 min group, a moxibustion for 40 min group and a moxibustion for 60 min group, with 8 rats in each group. Rats in the normal group did not receive modeling and moxibustion intervention; rats in the model group did not receive moxibustion after modeling; rats in the moxibustion for 20 min group, the moxibustion for 40 min group and the moxibustion for 60 min group were treated with moxibustion at Shenshu (BL 23) and Zusanli (ST 36) for 20 min, 40 min and 60 min, respectively. Six days were a course of treatment, with a total of 3-course treatments and a 1-day rest between the courses of treatment. After treatment, the serum levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α, arthritis index (AI) scores, toe volumes and pathological score of synovitis were evaluated in the rats.Results: Compared with the normal group, the serum IL-1β and TNF-α levels, and the toe volumes in the model group were increased, and the differences were statistically significant (P<0.01), before the treatment. Compared with the model group, the serum IL-1β and TNF-α levels, toe volumes and arthritis index (AI) scores were significantly decreased in the moxibustion for 20 min group, the moxibustion for 40 min group and the moxibustion for 60 min group (P<0.05 orP<0.01 ). Compared with the moxibustion for 20 min group and the moxibustion for 60 min group, serum IL-1β and TNF-α levels, toe volumes and AI scores were decreased more significantly in moxibustion for 40 min group, and the differences were statistically significant (P<0.05 orP<0.01). There were no significant differences in serum IL-1β and TNF-α levels, AI scores and toe volumes between the moxibustion for 20 min group and the moxibustion for 60 min group (allP>0.05). The synovial histopathological improvement was the most obvious in the moxibustion for 40 min group, when the synovial histopathological changes were compared among the moxibustion for 20 min group, moxibustion for 40 min group and moxibustion for 60 min group.Conclusion: The therapeutic efficacy of moxibustion for 40 min in RA rats was more significant than that of moxibustion for 20 min and moxibustion for 60 min, indicating that the duration of moxibustion is the main factor affecting its therapeutic efficacy.

Animals ; Hypoxia ; classification ; metabolism ; Male ; Oxygen Consumption ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the application value of hyperinsulinemic euglycemic clamp in the diagnosis and treatment of newly-onset diabetic patients. Methods Totally 11 newly-onset diabetic inpatients (10 patients with type 2 diabetes mellitus and 1 patient with latent autoimmune diabetes of adulthood) who were diagnosed in the Department of Endocrinology of Peking Union Medical College Hospital from January 2009 to August 2009 were included in this study. Hyperinsulinemic euglycemic clamp was applied to measure the glucose disposal rate (M value). Afterwards insulin pump therapy was applied and the total insulin dosage per day to get to the target of the fasting and postprandial blood glucose was calculated. Final]y the relationships between insulin dosage per day and the M value, body mass index (BMI) , fasting blood glucose, fasting insulin level were separately analyzed. Results The insulin dosage was only negatively correlated with M value (r = - 0. 83, P = 0. 003), and was not significantly correlated with BMI (r = 0.54, P = 0.106), fasting blood glucose (r = - 0. 16, P =0. 657) , and fasting insulin (r = 0. 16, P = 0. 659). The formula of insulin dosage and M value according to the mathematic model as follows: insulin dosage per day = - 3. 327 M + 49. 849. Conclusion Hyperinsulinemic euglycemic clamp can effectively evaluate the insulin sensitivity in the newly-onset type 2 diabetic patients, and thus can be a useful tool in deciding the clinical insulin dosage.