Objective To discuss the early diagnosis and interventional therapy of acute renal infarction.Methods The diagnosis and therapy of 5 cases of acute renal infarction were retrospectively analyzed.There were 4 male and 1 female patients,aged 38-68 years.The symptoms were severe back pain or upper abdominal pain,with or without nausea and vomiting and the time to hospital was 1 to 16 h.Four cases had rheumatic heart disease and 4 cases had artrial fibrillation history.The lab assay results: WBC 8.9-15.8 × 109/L,urine RBC-to + + +,albumin + to + + +,serum creatinin 66-216 μmol/L,serum LDH 350-920 U/L.The doppler ultrasound and CT scan showed large infarction in 3 cases and focal infarction in 2 cases.Percutaneous arteriography,thrombolytic therapy and thrombosuction via catheter were applied promptly.Results The 5 cases were diagnosed and treated timely and effectively.The emboli were cleared.Four patients were followed up for 3-12 months.The creatinin recovered to 53-122 μmol/L,and the blood perfusion of the infarction lesion was satisfactory.Conclusions Early diagnosis and interventional therapy is important for achieving satisfactory recovery of the acute renal infarction.Three dimensional CT angiography could conduce to early diagnosis and follow-up.Thrombosuction via catheter plus thrombolytic therapy is efficient for greater embolus.

Objective To study the reversal effect of tetrandrine (TET) on the multidrug resistance of Hep-2/ADM cell line and the possible mechanisms. Methods MTT method was used for the detection of the inhibitory effect of different concentrations of TET on the multidrug resistance of Hep-2/ADM cell line for selection of the non-toxicity concentration. MTT reduction assay was used to investigate the drug interaction of TET and vincristine (VCR) on HNE-1 (200) cell line. The reversal index (RI), accumulation and excretion of drug, and the apoptosis of Hep-2/ADM cell line were detected by flow cytometry. Results No toxicity to Hep-2/ADM cell line was found when TET concentration was lower than 1.5 ?g/ml. After interaction with TET (1.0 ?g/ml and 1.5 ?g/ml), RIs of VCR on Hep-2/ADM were 1.72 and 2.00 folds, respectively. TET at the concentration of 1.5 ?g/ml could increase the drug excretion and accumulation and also the apoptotic rate of VCR-induced Hep-2/ADM cell line. Conclusion TET can reverse the multidrug resistance of Hep-2/ADM cell line. The reversal effect may be related to the concentrations of TET. The possible mechanism may be that TET can increase the cell apoptosis of VCR-induced Hep-2/ADM cell line and can also increase the drug excretion and accumulation of the multidrug resistance cell line.

Objective To compare the effect of 5-fluorouridine(5-FUR) prodrug liposome on the cell proliferation and apoptosis in HEP-2 cells.Methods MTT assay was used to investigate the cell proliferation after 5-FU or 5-FUR prodrug liposome at the dose of 3.0,0.6,0.12 or 0.024 ?g/ml was added into the culture medium of HEP-2 cells for 72 h.Flow cytometry(FCM) was used to measure the cell cycle when the cells were treated with 0.17 ?g/ml 5-FU or 0.05 ?g/ml 5-FUR prodrug liposome for 72 h.The apoptosis of cells treated with 0.05 ?g/ml 5-FU or 5-FUR for 48 h were assayed with FCM.Results The IC50 of 5-FU on HEP-2 cells was 300% higher when compared with 5-FUR prodrug liposome.Treated with 5-FU and 5-FUR prodrug liposome respectively,HEP-2 cell lines were both arrested at S stage.the apoptosis rate of HEP-2 were(10.35?1.33)% and(21.57?0.11)% respectively.Conclusion Compared with 5-FU,5-FUR prodrug liposome inhibits the cell proliferation of HEP-2 cells more significantly,arrests more cells at S phase,and improves cell apoptosis.

ObjectiveTo summarize and investigate the incidence,reason,diagnosis and treatment of postoperative early cardiac arrhythmia after orthotopic liver transplantation(OLT).Method A retrospective study was made for the incidence,dignosis and treatment of cardiac arrhythmia (two weeks after OLT) following OLT from June 2004 to January 2012 in the Beijing You-An Hospital.ResultsIn 500 patients who received OLT,Cardiac arrhythmia developed in 82 patients (16.4％).Among these cardiac arrhythmia,35(7.0 ％) were sick sinus syndrome (including severe sinus bradycardia ),18 (3.6 ％ ) were paroxysmal supraventricular tachycardia,21(4.2 ％) were atrial fibrillation,8(1.6 ％,including 2 patients with torsades de pointes) were ventricular tachycardia and 4 (0.8 ％ )were cardiac arrest.Mortality rate after OLT relate to cardiac arrhythmia was 0.4％ (2 patients).Cardiac arrhythmia was mainly correlated with four factors:(1)whether patient had heart disease before OLT or not(x2 =15.82,P＜0.01),(2)Prolonged QT interval in patients with end-stage liver disease before OLT(x2 =11.00,P＜0.01).ConclusionsCardiac arrhythmia was common complication after OLT,and it can lead to death of recipients.Careful evaluation to recipients before OLT,controlling fluid load after OLT,keeping the balance of the electrolyte,acidity and alkalescence,giving intensive monitor to patients with heart disease before OLT and prolonged QT interval are the key factor to reduce incidence and mortality of cardiac arrhythmia.Application of medication and cardiac pacemaker can prevent cardiovascular accident after OLT.

OBJECTIVETo investigate the clinical outcomes of the posterior C1,2 screw-rod combined with C2 unilateral translaminar screw and contralateral pedicle screw fixation and autogenous bicortical iliac crest graft fusion in treating upper cervical instability with vertebral artery variations.

METHODSFrom June 2008 to December 2012, the clinical data of 12 patients with upper cervical instability underwent C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion were analyzed retrospectively. There were 8 males and 4 females with a mean age of 47.5 years (ranged, 16 to 77 years). Patients suffered from occipitocervical activity limitation of motion with pain or not, VAS was 0-7 points with an average of (3.50 +/- 2.71) points. Unilateral vertebral artery hypoplasia was demonstrated by vertebral arteriography (VAG) or CTA in all patients. Cervical X-ray and CT scans were done within 7 days after surgery in order to confirm internal fixation position. Internal fixation loosening and breakage, reduction losing, bone fusion ratio were observed during follow-up.

RESULTSNo nerves and vertebral artery injuries occurred during operation. Cervical pain obviously decreased and VAS was (0.92 +/- 0.90) points. Cervical alignment of 12 patients had well-recovered by X-ray while Atlantoaxial ventral lamina cortex of 1 case was encroached by CT scan without neurological symptom. All patients were followed up for 6 months to 3 years, no internal fixation loosening and breakage, reduction losing were found. All patients obtained bone fusion in 6-12 months after operation.

CONCLUSIONPosterior C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion can achieve biomechanical stability and raise the successful rate of bone fusion, while avoiding the risk of vertebral artery injury and overcoming the insufficient of bone fusion during bilateral laminar screws placement as well. Posterior C1 lateral mass screws fixation is a safe and effective additional method in treating upper cervical instability with vertebral artery variations.

Adolescent ; Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Internal Fixators ; Joint Instability ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; pathology

Objective To investigate the effects of trimebutine maleate (TM) on the expression of large conductance calcium-activated potassium channel (BKCa) and ryanodine receptors (RyR)channels at mRNA and protein level in colonic smooth muscle cell of cold restraint stress(CRS)induced rats.Methods A total of 24 Wistar rats were divided into CRS group,CRS with TM group and control group equally.The rats of CRS group were gavaged with 0.9％NaCl (6 ml/kg) daily; the rats of CRS with TM group were gavaged with 15 g/L TM (6 ml/kg) daily and activity was restricted in wire cage at 4 ℃ for two hours,continuously for five days.The rats of control group were gavaged with 0.9 ％ NaCl (6 ml/kg) once without CRS.The amount and characteristics of stool of rats in each group were observed.The colonic smooth muscle was isolated to detect the expression of BKCa and RyR at mRNA and protein level by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results The median of rats defecation particles of CRS group was six,control group was one and CRS with TM group was five.Compared with control group,the defecation appearance of CRS group and CRS with TM group was looser and wetter observed by naked eyes.Compared with control group,there was no obvious pathological changes in CRS and CRS with TM group.There was no significant difference in the mRNA expression of BKCa and RyR channels between control group and CRS group.Compared with control group,the BKCa expression at mRNA level of CRS with TM group increased 1.45 fold.Compared with control group,the RyR2 expression at mRNA level of CRS with TM group increased 1.32 fold.Compared with control group,the BKCa expression at protein level of CRS with TM group increased 1.39 fold,and there was no RyR2 expression band at protein level.Conclusion TM might affect colonic smooth muscle contraction through the upregulation of BKCa expression at mRNA and protein level and RyR expression at mRNA level.

Objective:To examine metastatic gastric cancer patients who underwent surgery after chemotherapy and to determine the factors affecting survival. Methods:Clinical data on metastatic gastric cancer patients who underwent surgery after chemotherapy were retrospectively analyzed. The overall survival data were evaluated through the Kaplan-Meier method, Log-rank test, and Cox haz-ards regression. Results:The median age was 46 (22~74), and the median overall survival rate (OS) was 19 months (4~59 months). Response to chemotherapy (23.0 m for PR and 14.5 m for SD, P=0.045) and resection of the primary tumor (23.0 and 5.5 m, respective-ly, P=0.017) affected OS. No single factor was related to OS according to Cox regression. Conclusion:Surgical removal of the primary tumor is recommended for metastatic gastric cancer patients with positive response to chemotherapy and with a primary tumor that can be resected.

BACKGROUND:Whole body vibration training, a recently developed method of neuromuscular training, is a useful method to improve muscle strength and postural control in the elderly. Recently, researchers attempt to explore whether whole body vibration training can reduce motor dysfunction for stroke patients.
OBJECTIVE:To summarize clinical progress in whole body vibration treatment on stroke patients with limb motor dysfunction, including muscle strength of the affected limbs, muscle tension, balance and gait.
METHODPubMed, EBSCO, Medline database were searched for articles relate to whole body vibration training intervention for stroke patients with motor dysfunction published from January 2002 to June 2014. Final y, 34 articles were included in result analysis.
RESULTS AND CONCLUSION:Whole body vibration training is feasible and safe for stroke patients has the feasibility and safety. For therapeutic efficacy, we focus on the muscle strength, muscle tone, balance, posture control ability, but there is no sufficient evidence to support that the whole body vibration training can improve the motor dysfunction. There is also no recognized standard on specific intervention protocols, such as vibration type, treatment frequency, treatment amplitude, treatment time. Many researchers aim to observe the clinical curative effect at present, but rarely explore the intervention mechanism of the whole body vibration. Further large-sample, multi-center randomized control ed experiments are required to test the validity.

Adolescent ; Adult ; Anticoagulants ; poisoning ; Coagulation Protein Disorders ; chemically induced ; diagnosis ; therapy ; Female ; Humans ; Male ; Rodenticides ; poisoning

Objective To explore the role of proton MR spectroscopic imaging(1H-MRSI)and diffusion tensor imaging(DTI)in the diagnosis of adrenoleukodystrophy and to demonstrate the involvement of fibers by using the technique of DTT.Methods 1H-MRSI,DTI and routine imaging examinations were performed in 6 patients with ALD.The values of NAA,Cho,Cr,ADC,and FA were evaluated in different regions of lesion.The involved fibers were demonstrated by using the technique of DTT.Results The ratios of NAA/Cr(0.55±0.19)and NAA/Cho(0.22±0.11)were lower(F=7.693,7.751),and Cho/Cr(2.54±0.37)was higher(F=6.348)in the initial lesions,where higher ADC values(1.49±0.36,F=5.226)and the lowest FA values(0.21±0.08,F=5.139)were also observed(P＜0.05).The decreases of NAA/Cr(1.16±0.03)and NAA/Cho(0.45±0.17)in adjacent regions were more distinct than those of remote regions(t=1.769,1.842,P＜0.05).In the developing regions,the ADC values(0.89±0.03)were lower and the FA values(0.45±0.07)were the highest.There was negative correlation between NAA/Cho and ADC values(r=-0.71,P＜0.05),and there was positive correlation between NAA/Cho and FA values(r=0.31,P＜0.05).Discontinuations and fragments of fibres were observed in corpus callosum and pyramidal tract.Conclusions Combination of 1H-MRSI and DTI can offer a sensitive method for the early diagnosis and monitor the progress of white matter.DTT can be used to directly observe the involvement of fibers.