Objective To evaluate the clinical diagnostic value of coronary artery calcification score(CACS)of multi-slice spiral computed tomography(MSCT)combined with carotid intima-media thickness(IMT)measure in elderly patients with coronary artery disease(CAD). Methods　CACS of MSCT,carotid IMT measure,and coronary angiography were performed in 68 patients,including 36 cases with CAD(CAD group)diagnosed by coronary angiography and 32 cases(control group)with coronary arterial stenosis(＜50% stenosis).CACS and carotid IMT were compared between two groups. Results　The coronary artery calcification score was significantly increased in CAD group compared with the control group[(349.5±86.3)vs.(74.7±25.2),t=13.670,P＜0.01],and it was increased with the severity of coronary arterial stenosis.The carotid intima-media thickness in CAD group showed significant difference with that in control group[(1.11±0.05)mm vs(0.69±0.13)mm,t=13.587,P＜0.01].In CAD group,CACS exhibited a significant positive correlation with carotid IMT(r=0.950,P＜0.01).The positive rates of CACS and carotid IMT were both 77.8% (28 cases)in CAD group and both 12.5%(4 cases)in control group,which showed significant difference between two groups(X2=28.976,P＜0.01). Conclusions　CACS of MSCT combined with carotid IMT have high sensitivity and specificity in evaluating coronary arteriaI stenosis.It can be used as a non-invasive examination to diagnose CAD in the elderly.

The relationship between 3 polymorphisms sites [interleulin-4 (IL-4), IL-4 receptor (IL-4R) alpha chain and activation-induced cytidine deaminase (AICDA)] and adult allergic asthma in China was studied. By using case-control method, DNA and clinical data were obtained from allergic asthmatic patients and compared with those in the control subjects. The subjects were genotyped for the IL-4 C-589T promoter polymorphism, the IL-4R alpha chain Q576R and the AICDA C8408T by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The results showed that the IL-4 C-589T was not associated with adult allergic asthma in China. However, the IL-4R alpha chain 576R/R and AICDA 8408T/T frequency was significantly increased in allergic asthma group as compared with that in the control group [odd ratio (OR) = 3.797 and 9.127, respectively; P < 0.01)] and was correlated with the increased plasma total IgE. These data suggested that the IL-4R alpha chain 576R/R and AICDA 8408T/T genotypes confer genetic susceptibility to adult allergic asthma in China.
Alleles ; Asthma/etiology ; Asthma/*genetics ; Cytidine Deaminase/*genetics ; Immunoglobulin E/blood ; Interleukin-4/*genetics ; Phenotype ; *Polymorphism, Restriction Fragment Length ; RNA Processing, Post-Transcriptional ; Receptors, Interleukin-4/*genetics

BACKGROUND:Arthroscopic treatment of tibial eminence fracture requires tiny wire,induces less epiphyseal plate damage during operations,obtains strong fixations,alows early movement postoperatively,obviously attenuate the injuries,facilitate wound healing,and reduce complications.OBJECTIVE:To investigate the biocompatibility of arthroscopic reduction and wire fixation in treatment of fresh and old tibial eminence fractures.METHODS:Twenty-five patients with fresh and old tibial eminence fractures were treated with arthroscopic reduction and wire fixation from January 2010 to April 2012 in the Second People's Hospital of Yichang City.The postoperative fracture healing time and knee function improvement in the two groups were observed.RESULTS AND CONCLUSION: Compared with the fresh fracture patients,the fracture healing time was longer,Lachman test positive rate was higher in the old fracture patients than (P＜0.05),knee flexion and extension activity and Lysholm score were lower (P＜0.05).Experimental findings indicate that,arthroscopic reduction and wire fixation is a feasible clinical treatment of fresh and old tibial intercondylar eminence fractures.

Objective To establish a novel chronic compressive cervical spinal cord injury rat model,to validate the chronic pathological characteristic.Methods Fifty-four SD rats were randomly divided into 3 groups,including control group(n =6),acute compressive group(4 h,24 h,respectively.n =6),and chronic compressive group(4 h,12 h,24 h,48 h,72 h and 1week,respectively.n =6).Two sizes of water-absorbing polyurethane polymer sheets were implanted into C5～6 epidural space on postero-lateral side in acute and chronic compressive group respectively,to induce a consistent compression in the cord after expanded.While a laminectomy on C5～6 was performed only in control group.The neurological integrity,MRI signal change in the cords,large motoneuron number in the ventral horn,and myelin staining intensity on posterior funiculus were studied.Results In the acute group at 4-24 h,the compression was confirmed significantly on T2WI image,as well as hypointense signal change intramedullary.These changes were consisted with intramedullary bleeding,tissue necrosis.Large motoneuron number(P ＜ 0.05),rather than myelin staining intensity (P ＞ 0.05),was significantly decreased compared with the control group and chronic compressive group.BBB score was 6.0 at 24 h.In the chronic group:cord distortion with progressive compression was observed on T2WI image,but without intramedullary bleeding signal change.At 4-12 h,intramedullary edema,central canal distortion were seen in the cords.Large motoneuron number and myelin staining intensity decrement were not significant(P ＞0.05).BBB score was 20.6.At 24-72 h,central canal enlargement,venous congestion,and edema were observed.Large motoneuron number was less than that in the control group.In the compressive epicenter,nerve fiber disorganization or rupture was observed.Myelin staining intensity decreased significantly after 48 h and 72 h compression (P ＜0.05).BBB score was 19.3.At lweek,vacuolation changes were noted and large motoneuron decreased (P ＜ O.05),as well as myelin density and staining intensity (P ＜ 0.05),suggesting nerve fiber demyelination.BBB score was 17.5.In the control group,there was no neurological deficit and pathological change in the cords.Conclusion The pathology and MRI characteristic consistent with chronic compressive injury change,which proved this method is able to induce a chronic course on the rat model,and established a reliable model foundation for cervical myelopathy.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; diagnosis ; surgery ; Lumbar Vertebrae ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Thoracic Vertebrae ; surgery ; Treatment Outcome

Objective To explore disinfection efficacy of anerdian using swab and spray disinfection methods.Methods Hands of 30 subjects were randomly divided into the swab group and the spray group.The samples of before and after disinfection in each group were collected separately and observed their disinfection effect.Results The number of bacteria showed no significant difference between the two groups.The passing rate of disinfection reached 100％.The time of disinfection in the spray group was (2.58±0.32)s,significantly less than that in the swab group,(12.26±1.48)s,however,the drying time in the spray group was (42.37±1.79)s,significant longer than that in the swab group,(26.24±1.46)s.A subject hand disinfection used 0.5ml 0.2％ anerdian in the spray group,and 0.75ml 0.2％ anerdian and two cotton buds was used in the swab group.Conclusions There is identical disinfection efficacy between spray and swab methods.Spray disinfection method has short operating time,less use of disinfectant without using cotton buds,it is able to replace swab disinfection and will play an important role to reduce medical waste and health care costs.

BACKGROUND:It is reported that bone marrow mesenchymal stem cell(BMSC)transplantation might be a promising treatment for liver fibrosis.But the mechanism is still unclear.OBJECTIVE:To observe the hepatic stellate cells apoptosis induced by BMSC transplantation,and to study the mechanism of BMSC in treating hepatic fibrosis in vivo.METHODS:CCl_4 subcutaneous injection was performed to induce rat liver fibrosis.After 8 weeks of CCU injection,20 rats which underwent successful model establishment were randomly divided into experimental group and control group,10 in each group.The experimental group received MSC transplantation via tail vein injection,and the control group were given DMEM instead.The rats were killed and the livers were harvested at three time point,the day of MSC transplantation,3 days after transplantation,and 7 days after transplantation.The hydroxyproline content was detected by HE and Masson staining,and the expression changes of α-smooth muscle actin(α-SMA)proteins were determined using immunohistochemistry.The apoptosis of hepatic stellate cells were determined by α-SMA and TUNEL(terminal dUTP nick-end labeling)dual-staining.RESULTS AND CONCLUSION:After 8 weeks of CCU injection,the hydroxyproline content increased and histology indicated progress of liver fibrosis.At 7 days after MSC transplantation,the hydroxyproline in the liver was decreased,and the liver fibrosis was alleviated in the experimental group but aggravated in the control group.Immunohistochemistry indicated that α-SMA positive cells were increased at 8 weeks after CCU injection.At day 7 after transplantation,α-SMA positive cells in the experimental group were significantly less than control group(P ＜ 0.05).At 3 days after transplantation,the hepatic stellate cells apoptosis in the experimental group was significantly aggravated compared with control group(P ＜ 0.05).This suggested that MSC transplant was an effective treatment for liver fibrosis.MSC inducing hepatic stellate cells apoptosis may be one of the mechanisms.

Objective To evaluate the efficacy and feasibility of Flu/ivBu/Tl" conditioning regimen for the treatment of refractory or relapsed acute non-lymphocytic leukemia in patients receiving allogeneic hematopoietie stem cell transplantation. Methods Seven patients with refractory or relapsed acute non-lymphocytic leukemia received HLA identical peripheral blood hematopoietie stem cell transplantation (PBSCT) following Flu/ivBu/TY conditioning regimen, which consisted of fludarbine, busulfex and thiotepa. All patients received cyclos-porin A (CsA) and mycophenolet mofetil (MMF) for prophylaxis of graft - versus - host disease (GVHD). Results The Flu/IVBu/TT regimen was tolerated very well, without severe regimen related toxicity. In the 31-month median follow-up duration, 5 of 7 patients were a-live in disease-free situation. Conclusion The Flu/ivBu/TT conditioning regimen reduced transplantation-related toxicities and offered high long-term disease-free survival, and was tolerated very well. Allogeneie hematopoietie stem cell transplantation using Flu/ivBu/TT condition-ing regimen is a safe and effective option for the patients with refractory/relapsed acute non-lymphocytic leukemia.

Objective To evaluate the efficacy of Flu/CTX conditioning regimen for the treatment of severe aplastic anemia in pa- tients receiving allogeneic hematopoietic stem cell transplantation. Methods Nine patients with severe aplastic anemia received HLA identi- cal peripheral blood hematopoietic stem cell transplantation (PBSCT) using Flu/CTX conditioning regimen, which consisted of fludarbine [30 mg/(m2 d) for5 days (-7 to -3) ], CTX [50mg/(kg d) for4 days(-5 to-2)]. All patients received cyclosporin A (CsA) and mycophenolet mofetil (MMF) for prophylaxis of graft-versus-host disease(GVHD). Results The Fiu/CTX regimen was very well toler- ated, with no severe regimen related toxicity. In all patients, the median days of neutrephil exceeding 0. 5×109/L and platelet exceeding 20 ×109/L were 12 days (range 10-16 days) and 16 days (range 14-19 days), respectively. Complete chimerism was achieved in all pa- tients at one month after PBSCT. Two patients had acute GVHD and one had chronic GVHD. In the 39-month median follow-up duration, all patients were alive in disease-free situation. Conclusion The Flu/CTX conditioning regimen may reduce transplantation-related toxicities and can achieve full chimerism and high long-term disease-free survival. Allogeneic hematopoietic stem cell transplantation using intravenous Fiu/CTX conditioning regimen is a safe and effective treatment method for the patients with severe aplastic anemia.

Hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC) is one of the most frequently occurring cancers. Hepadnaviral DNA integrations are considered to be essential agents which can promote the process of the hepatocarcinogenesis. More and more researches were designed to find the relationship of the two. In this study, we investigated whether HBV DNA integration occurred at sites of DNA double-strand breaks (DSBs), one of the most detrimental DNA damage. An 18-bp I-SceI homing endonuclease recognition site was introduced into the DNA of HepG2 cell line by stable DNA transfection, then cells were incubated in patients' serum with high HBV DNA copies and at the same time, DSBs were induced by transient expression of I-SceI after transfection of an I-SceI expression vector. By using nest PCR, the viral DNA was detected at the sites of the break. It appeared that integration occurred between part of HBV x gene and the I-SceI induced breaks. The results suggested that DSBs, as the DNA damages, may serve as potential targets for hepadnaviral DNA insertion and the integrants would lead to widespread host genome changes necessarily. It provided a new site to investigate the integration.