Objective To investigate the clinical characteristics and treatment of senile patients with lumbar disc protrusion . Methods The clinical data of 56 cases of senile lumbar disc protrusion from 1990 to 2000 were reviewed retrospectively. Results 48 patients had been followed for 6 months to 7.5 years with average 4 years. Excellent and good results were 41 cases (85.4%).Conclusions There was atypical symptom in the senile patients with lumbar disc protrusion. CT was an important methods for diagnosis. The after concomitant diseases were controlled, resecting half vertebral lamina and enlarging fenestration were performed. The therapeutic results were satisfactory.

Objective To investigate the transition of uropathogens and drug resistance in patients with type 2 diabetes(T2DM)complicated with urinary tract infection(UTI)in recent 10 years.Methods A total of 392 cases of T2DM with UTI were included in the study.The patients were divided into 2 groups according to time of hospitalization:group A(January 1998 to December 2002)and group B(January 2003 to December 2007).Clinical information,distilbution of uropathogens and antibiotic resistance between the two groups were analyzed.Results The most common pathogens isolated were Escherichia coli(50/152,32.89%),followed by Candida albicans(21/152,13.82%)and Enterococcus faecium(15/152,9.87%).Of the various pathogenic organisms isolated in group B,there were 16 new species not seen in group A.Escherichia coli was found to have higher resistant rates to ciprofloxacin and ceftriaxone in group B than in group A(80.8%vs.42.8%,26.9%vs.0,respectively).Enterococcus faecium was found to be more susceptibility to tetracycline in group B than in group A(0 vs.100.O%).Conclusion Species of uropathogens in T2DM patients ale increased,and the isolates are of high drug resistance,which should be noted in clinic.

Objective To improve the clinical efficacy of angina pectoris with dyslipidemia patients, analysis of the combined use of trimetazidine, atorvastatin calcium, the clinical value of psychological intervention.Methods 86 cases of patients with coronary heart disease and angina pectoris with dyslipidemia were selected, according to the random number table method is divided into control group and study group, each group of 43 cases. The control group were given routine symptomatic angina pectoris of coronary heart disease with abnormal blood lipid therapy plus trimetazidine hydrochloride oral Sibutramine, study group on the basis of the control group given oral atorvastatin calcium plus psychological intervention of statin treatment. Results After treatment, the clinical efficiency of the study group and the control group was 95.34％ and 81.4％, the difference between the two groups was statistically significant (P<0.05); patients in the study group SDS, SAS score than the control group, the difference between the two groups was statistically significant (P<0.05); patients in the study group, TC, TG, LDL and C levels were significantly lower than the control group, the HDL level of C higher than that of control group, the difference between the two groups was statistically significant (P<0.05); study on patients with angina pectoris attack times less than the control group, the seizure duration shorter than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Psychological intervention combined with the treatment of angina pectoris of coronary heart disease with abnormal blood lipid, clinical efficiency increased from 81.4％ to 95.34％, reduced in patients with depression, anxiety and other negative emotions, so that the blood has been effectively controlled, improve clinical symptoms, reduce the pain of patients, with high clinical value.

Objective To investigate the level and clinical significance of laminin (LN) and hyalu-ronic acid (HA) in cerebrospinal fluid (CSF) of patients with neuropsychiatric lupus (NPLE). Methods The level of LN and HA in CSF in 31 cases of NPLE, 36 cases of no-NPLE SLE, 23 cases of no-SLE cerebrovascular disease and 39 normal controls were messured by radioimmunoassay method. Results The level of LN and HA in CSF of NPLE patients was higher than that of the no-NPLE, no-SLE cerebrovascular disease and normal controls (P

Objective To explore the role of HIF-1 and its downstream SDF-1α/CXCR4 and VEGF/VEGFR pathway in mediating MSC mobilization with DMOG .Methods Male SD rats were randomly divided into five groups:Normal saline control group , DMOG group, YC-1 group, AMD3100 group, SU5416 group.We used CFU-F assay and flow cytometry to determine the number of MSCs in rat bone marrow ( BM ) and peripheral blood ( PB ) in each group , respectively.The concentrations of SDF-1αand VEGF both in BM and PB serum in each group were detected by ELISA . Western blotting was used to test protein levels of HIF-1α, SDF-1αand VEGF in BM.Results Compared with NS group, the number of CFU-Fs as well as the percentage of CD 45 -CD90 +cells increased in DMOG group ( P <0.05);Compared with DMOG group, the number of CFU-Fs as well as the percentage of CD 45 -CD90 +cells decreased in YC-1 group, AMD3100 group and SU5416 group (P <0.05).Compared with DMOG group, the concentration and protein expression of HIF-1αdecreased significantly in YC-1 group ( P <0.05 ) , the concentration and protein expression of SDF-1αdecreased significantly in AMD 3100 group ( P <0.05 ) , the concentration and protein expression of VEGF decreased significantly in SU5416 group ( P <0.05 ).Conclusion DMOG can induce MSCs mobilization possibly via up-regulating the expression of HIF-1αand activating its downstream SDF-1α/CXCR4 and VEGF/VEGFR pathway .

This study was aimed to observe the effect ofIllicium verum water extract on excess-cold syndrome in rats. The intragastric administration of the decoction of gypsum, gentian, phellodendron andrhizoma anemarrhenae (2:1.2:1:1.5) was used to establish the excess-cold rat model. Effects ofI. verum water extract on general body signs of excess-cold syndrome rats were observed. The detection was made on the contents of LD, PA, TG, TSH, T4 in the serum and LD, PA, glycogen in liver tissues. The vitality of the LDH, SDH and ATPas was also detected. The results showed thatI. verum water extract can improve the general body signs of excess-cold syndrome rats. It reduced the content of TG; increased the content of PA, T4, TSH; reduced the content of LD, glycogen, and the vitality of LDH;increased the vitality of LDH, Ca2+-Mg2+-ATPase in liver tissues. It was concluded thatI. verum water extract can improve some general body signs of excess-cold syndrome rats, improve the substance and energy metabolism, and regulate the thyroid axis function, in order to achieve the warmingyang for dispelling cold effect.

Objective To evaluate the clinical significance of rearrangements during transfection of papillary thyroid cancer (RET/PTC) 1,3 in fine needle aspiration (FNA) specimen from regional thyroid nodules by FQ-PCR.Methods Two hundred and eighty-five FNA samples were collected from patients with thyroid nodules during January 2012 to January 2013.RET/PTC1,3 rearrangements were detected with FQ-PCR.Results The frequencies of the RET/PTC1 and RET/PTC3 rearrangements in 285 FNA samples were 17.2％ (49/285) and 1.4％ (4/285),respectively.During 21.7 months of follow-up,19 (40.4％,19/47) RET/PTC1 positive patients were confirmed to have papillary thyroid carcinoma(PTC) after operation.In the patients with RET/PTC1 rearrangement PTC was found in Thy5 and Thy4 groups.In Thy 2 group,22.6％ cases with RET/PTC1 rearrangements developed PTC as compared with 3.2％ cases without it(x2 =6.667,P＜0.01).In addition,8.5％ (4/47) RET/PTC1 rearrangements emerged in benign lesions.Conclusions It is convenient and reliable to detect RET/PTC1,3 rearrangements by FQ-PCR using FNA samples.RET/PTC1 rearrangement frequently occurs in PTC,however it would be detected in benign lesions occasionally.

Objective To evaluate the effects of normovolemic hemodilution (NH) with hetastarch starch 130/0.4 and electrolyte solution on blood coagulation during resection for liver cancer in the elderly patients.Methods Forty patients,of ASA physical status Ⅱ,aged 65-74 yr,scheduled for elective resection for liver cancer under general anesthesia,were randomly divided into NH group (n =20) and control group (group C,n =20).NH group underwent NH with 6％ hematocrit starch 130/0.4 and electrolyte solution after induction of anesthesia,while group C underwent routine fluid management.Before induction of anesthesia (T1),at 30 min after NH (T2),at 1 h during operation (T3),and at the end of operation (T4),venous blood samples were collected for measurement of the routine parameters of blood coagulation,and levels of soluble fibrin monomer complex (SFMC),and platelet membrane glycoprotein (PAC-1,platelet activation marker).Results Compared with group C,no significant changes were found in intraoperative blood loss,PT,APTT,and levels of SFMC and PAC-1,the volume of allogeneic blood transfused was reduced,and Fib was decreased at T2-4 in NH group.Compared with the baseline value at T1,Fib was decreased significantly at T2-4 in NH group,and PT and APTT were prolonged but still within the normal range,and no significant changes were found in the other parameters in both groups.Conclusion NH with hetastarch starch 130/0.4 and electrolyte solution exerts no effect on blood coagulation during resection for liver cancer and provides blood-saving effect to some extent in the elderly patients.

Lesch-Nyhan syndrome(LNS) is a congenital X-linked recessive inherited disorder caused by mutations in the hypoxanthine guanine phosphoribosyl transferase (HPRT) gene.A deficiency of the HPRT enzyme is responsible for the disease.The main clinical manifestation includes hyperuricemia, juvenile-onset gouty arthritis and neurological developmental disorders.Studies have reported there are more than 400 HPRT gene mutation sites, but the incidence of LNS in the Chinese population is extremely low.Here we report a 16-year-old male patient who suffered neurological dysfunction at an early age and gouty arthritis in his youth.DNA of patient and his family members were extracted from peripheral blood lymphocytes.The coding region and the intron-exon boundaries of HPRT gene were sequenced by standard methods.We found a mutation in exon 3 of the HPRT gene of the patient and his mother (Exon3:c.143G>A), which resulted in an arginine to histidine (p.R48H) substitution in the encoded protein.No activity of the enzyme HPRT was detected in the erythrocytes.The same mutation was reported in several European families, but was found in Chinese family for the first time.Clinicians in China have poor experience in diagnosing LNS case, due to the low incidence in China.Therefore LNS screening for infants or adolescents with hyperuricemia, gouty arthritis and neurological dysfunction should be performed.

Objective To evaluate the accuracy of anesthesia index (AI) for monitoring depth of sedation induced by propofol.Methods Thirty patients of both sexes,aged 41-64 yr,with body mass index of 20-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were enrolled in the study.Propofol was given by target-controlled infusion (TCI) with the initial target effect-site concentration (Ce) of 1.2 μg/ml using Marsh pharmacokinetic model,and then the Ce of propofol was increased in 0.3 μg/ml increment,and Observer's Assessment of Alertness/Sedation (OAA/S) score was evaluated.OAA/S score was 5 before TCI of propofol.When OAA/S score reached 4,3,2 and 1 in turn during TCI of propofol,the bispectral index (BIS),AI and corresponding Ce were recorded.Results The correlation coefficients of BIS,AI and Ce levels with the OAA/S scores were rBIS-OAA/S =0.962,rAI-OAA/S =0.960 and rce-OAA/S =-0.795,respectively (P＜0.05).The correlation coefficients of BIS and AI with the Ce of propofol were rBIs-ce =-0.736 and rAI-Ce =-0.737,respectively (P＜0.05).There was no significant difference between rBIS-OAA/s and rAI-oAA/S,and between rBIS-Ce and rAI-Ce (P＞ 0.05).Conclusion AI can accurately monitor the depth of sedation induced by propofol in adult patients without noxious stimuli and there is no significant change in the accuracy in comparison with BIS.