Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)injection in the treatment of spasmodic torticollis.Methods Sixty-four patients with spasmodic torticollis underwent the treatment of intramuscular injection of BTX-A in neck muscles.As a result,the efficiency of BTX-A therapy could be evaluated successfully.Results Considerable improvement of symptoms for the spasmodic torticollis patients was observed with BTX-A treatment.The average dose of BTX-A was(120.37 ±25.26) U.Injection points were 30.00 ± 4.85.The Tsui scores before treatment were (13.08 ±4.16) scores,and 2 weeks after treatment were (4.21 ± 2.63) scores.The Tsui scores showed a significant reduction after BTX-A injections (P <0.01).After treatment complete remission rate was 25.0% (16/64),significant improvement rate was 60.9% (39/64),partial improvement rate was 12.5% (8/64),invalid rate was 1.6%(1/64) and efficient rate was 85.9% (55/64).Duration of effect was (16.86-4.57) weeks.Patients who received repeated injections also had good response,with symptoms improved and dosage of BTX-A reduced.No serious adverse events happened in treatments.Conclusion BTX-A therapy is simple and effective in the treatment of spasmodic torticollis and should be considered as the first-choice treatment for the condition.

Objective To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis based on individual condition. Methods Twelve patients with intracranial venous sinus thrombosis were treated with endovascular management according to the severity and course of disease after they failed to respond to anticoagulant therapy. The clinical signs and symptoms,cerebrospinal fluid pressure and arteriovenous circulation time were observed and followed up (including MRV). Intravenous thrombolysis and mechanical thrombus maceration were carried out in all 12 patients,while intravenous thrombolysis, mechanical thrombus maceration in combination with intra-arterial thrombolysis were employed in 3. After the treatment, anticoagulant therapy was carried out for 6 months.The patients were followed up for 12 to 24 months. Results Of the twelve patients, clinical signs and symptoms included slight headache (2 cases), mild hemiplegia (1 case), ambiopia or blurred vision (3 cases). The cerebrospinal fluid pressure returned to under 26 cm H2O (1 cm H2O =0.098 kPa)following treatment from 28 to 38 cm H2O [ mean (32. 4 ±3.0) cm H2O] in preoperative measurement and the arteriovenous circulation time returned to below 10 s in all patients following treatment. Neither recurrence of thrombosis nor new symptoms of neurologic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation with the exception of a subcutaneous bleeding at the venopuncture site. Conclusion Endovascular treatment is effective and safe for patients with intracranial venous sinus thrombosis.

Objective To investigate the protective effects of Naoxintong capsule on cerebral ischemia-reperfusion injury in rats.Methods 45 SD rats were randomly divided into 5 groups: sham operation group (n=5), ischemia-reperfusion group (n=10), small dose of Naoxintong capsule group (n=10), large dose of Naoxintong capsule group (n=10), CoQ-10 group (n=10). The the cerebral ischemia-reperfusion model was established by occluding bilateral carotid arteries of animal. The moisture content and activity of ATPase in brain tissue of model rat were observed respectively at ischemia 30 min plus reperfusion 30 min and ischemia 30 min plus reperfusion 60 min.Results The activities of Na+-K+-ATPase, Ca2+-ATPase and Mg2+-ATPase decreased (P<0.01), contents of water in brain tissues increased (P<0.01) in the ischemia-reperfusion group, compared with the sham operation group. The activities of Na+-K+-ATPase, Ca2+-ATPase and Mg2+-ATPase increased (P<0.01), contents of water in brain tissues decreased (P<0.01) in the Naoxintong capsule group, compared with the ischemia-reperfusion group.Conclusion Naoxintong capsule can protect the brain tissue from ischemia-reperfusion injury.

Objective To analyze the characteristics of bone scintigraphy in 117 cases with primary hyperparathyroidism (PHPT).Methods Of these 117 cases (50 males and 67 females),there were 116 parathyroid adenomas and 1 parathyroid cancer.Mean age was 61.1(12-86) years old.All had ~(99)Tc~m-methylene diphosphonate (MDP) bone scintigraphy.The bone images could be classified into 4 categories.Category Ⅰ:normal;category Ⅱ:localized abnormal,which could be subcategorized as Ⅱ A with skull and mandible involvement,and Ⅱ B with Ⅱ A characteristics plus metabolic derangement;category Ⅲ:systemic,whole-body incmased tracer uptake;category Ⅳ:systemic plus localized metabolic derangement.Data were analyzed statistically with X~2 and t-test (isolated samples).Results According to the scintigraphic findings,there were 47 cases(40.17%)of category Ⅰ,35 cases(29.91%) category Ⅱ (21/35cases Ⅱ A and 14/35 cases Ⅱ B),30 cases (25.64%) category Ⅲ,and 5 cases (4.27%) category Ⅳ.Combining categories Ⅱ、Ⅲ and Ⅳ together,there were 70 abnormal cases.These patients had history of abnormal bone images such as bone fracture (39 cases,55.71%),calculus (8 cases,11.43%),bone fracture plus calculus(7 cases,10.00%),osteoporosis (51 cases,72.86%) or ostalgia(26 cases,37.14%);however,in the 47 cases of category Ⅰ,only 1 (2.13%),0,0,10(21.28%)and 10 cases (21.28%),respectively,were found.Therefore.these case history characteristics were statistically significant (X~2=11.152,P=0.01).The tumor size,parathyroid hormone (PTH),blood calcium,blood phosphorus in the patients of abnormal PHPT categories Ⅱ to Ⅲ were(14.52±13.72)cm~3,(731.67±618.40)ng/L,(3.05±0.29) mmol/L and (0.71±0.14) mmol/L,respectively.with statistically significant difference compared to category Ⅰ:(0.78±1.33) cm~3,(112.04±62.98)ng/L,(2.56±0.42) mmol/L and (1.03±0.36)mmol/L(t=-5.724,-5.741,-7.274 and -6.451;all P＜0.01).Conclusions (1)Bone scintigraphy was normal in 40% of PHPT patients.(2)The bone images of PHPT could be classified into 4 categories and each could reflect the duration and severity of the disease status on bone.(3)The bone imaging characteristic could be useful for differential diagnostic purposes.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. Methods: The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method. Results: Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%. Conclusion The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.

In order to realize the current situation and existing problems of integrative medicine of Chinese and Western medicine (ICWM) in China, a survey with questionnaires was conducted, its contents including the viewpoint of patients, who received ICWM therapy, on ICWM and on doctors of ICWM; the condition of ICWM researches; the present development of ICWM hospital and the existing problem in these hospital, etc. by inquiry on medical workers showed that most of them considered the best approach for medical research is the modern medical or the modern scientific studying method, and more than 71.2% patients prefered ICWM therapy the treatment most willing to receive.
Attitude of Health Personnel ; China ; Delivery of Health Care, Integrated ; methods ; Health Care Surveys ; Humans ; Medicine, Chinese Traditional ; Patient Satisfaction ; Surveys and Questionnaires

Objective To investigate the clinical characteristics,surgical experience and mid-term outcome of coronary artery bypass graft surgery in patients aged ≤ 40 years.Methods From Jan.,2009 to Dec.,2015,12 patients with median age of (37.9 ± 2.5) years (range 32-40 years,10 males) were diagnosed with coronary artery disease and underwent coronary artery bypass graft surgery at Zhongshan Hospital,Fudan University.The clinical characteristics included five cases with hypertension,three cases with diabetes mellitus,four cases with hyperlipemia,eight cases with smoking history,seven cases with myocardial infarction.Six cases had at least one branch totally occluded.Two cases once underwent percutaneous coronary intervention surgery and implanted with five and three stents respectively.The perioperative data and follow-up results were retrospectively analysed.Results There was no in-hospital death and no death during follow-up period.Surgical techniques included bilateral internal mammary arteries combined with radial artery were operated in six cases,bilateral internal mammary arteries combined with great saphenous vein in two cases,left internal mammary arteries combined with great saphenous vein in four cases,off-pump in nine cases and on-pump in three cases.The mean follow-up time was (47.8 ± 24.3) months.During the follow-up one case suffered with saphenous vein graft restenosis 5 years after the surgery and underwent percutaneous coronary intervention.Other cases were all alive and assessed New York Heart Association's function class Ⅰ-Ⅱ.Conclusions Younger patients usually suffer with severe coronary artery disease when diagnosed because they often have excellent compensative capacity and the pathogenesis is concealed.The mid-term results of coronary artery bypass graft surgery in patients aged ≤40 years are satisfactory.

OBJECTIVETo explore the silencing effects of RNA interference on the expression of 3-phosphoinositide-dependent protein kinase 1 (PDK1) gene, and the effects on malignant phenotypes of esophageal carcinoma EC9706 cells.

METHODSPDK1 siRNAs was transfected into the EC9706 cells. The expression of PDK1 mRNA was detected by reverse transcriptase polymerase chain reaction (RT-PCR). At the same time, expressions of PDK1, Akt and phosphorylated Akt proteins were detected by Western blot. Methyl thiazolyl tetrazolium assay (MTT) was used to examine the cell proliferation after transfection. Flow cytometry was used to determine the percentage of apoptosis cells, and Transwell chambers were used to detect the invasion ability of the cells. Tumor formation in nude mice was used to assess the tumorigenic characteristics in vivo.

RESULTSCompared with the non-transfected group, PDK1 siRNA effectively inhibited the expression of PDK1 mRNA in EC9706 cells, with an inhibition rate of (28.5 ± 4.2)% at 24 h, (51.1 ± 5.7)% at 48 h and (60.6 ± 4.1)% at 72 h after transfection. The expressions of PDK1 and phosphorylated Akt protein were also knocked down by PDK1 siRNA (P < 0.05). PDK1 siRNA significantly inhibited the cell proliferation and invasion, promoted the cell apoptosis, and inhibited the EC9706 cells proliferation in vivo and the expression of PDK1 protein in the transplanted tumors (P < 0.05).

CONCLUSIONPDK1 may play an important role in esophageal cancer cell proliferation, invasion and apoptosis, and may serve as an effective target for cancer gene therapy.

3-Phosphoinositide-Dependent Protein Kinases ; Animals ; Apoptosis ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Esophageal Neoplasms ; genetics ; metabolism ; pathology ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Invasiveness ; Neoplasm Transplantation ; Phosphorylation ; Protein-Serine-Threonine Kinases ; genetics ; metabolism ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; RNA Interference ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Transfection ; Tumor Burden

To study the effect of Yinghua Pinggan granule (YHPG) against influenza A/H1N1 virus in vivo and on the immunologic function of infected mice. The intranasal influenza virus infection was adopted in ICR mouse to establish the influenza virus pneumonia model. At the 3rd and 7th day after the infection, the lung index and pathologic changes in lung tissues of mice were detected. Realtime PCR and flow cytometry were employed to observe the virus load in lung tissues and the levels of CD4+, CD8+, and CD4+/CD8+ in peripheral blood. The result showed that at the 3rd and 7th day after the infection, YHPG (15, 30 g x kg(-1)) can significant decrease in the lung index and virus load in lung tissues of mice infected with influenza virus, alleviate the pathologic changes in lung tissues, significantly increase the levels of CD4+ and CD4+/CD8+ ratio and reduce the levels of CD8+ in whole blood. This indicated that YHPG can inhibit the influenza virus replication, alleviate pulmonary damage and adjust the weak immunologic function of infected mice, with a certain therapeutic effect on mice infected by H1N1 virus in vivo.
Animals ; Antiviral Agents ; administration & dosage ; Humans ; Influenza A Virus, H1N1 Subtype ; drug effects ; genetics ; physiology ; Influenza, Human ; drug therapy ; pathology ; virology ; Lung ; pathology ; virology ; Male ; Mice ; Mice, Inbred ICR ; Virus Replication ; drug effects

Objective To evaluate the efficacy of 131I treatment for bone metastases from DTC and analyze the survival rates after 131I treatment and prognostic factors. Methods One hundred and six DTC patients with bone metastases treated by 131I during January 1991 and January 2009 were retrospectively analyzed. Treatment efficacy was assessed based on serum Tg change, bone pain palliation and changes on medical imaging. Univariate analysis was performed for defining the factors affecting 131I treatment efficacy. Survival curves were estimated using the life table method. Survival analysis was performed using Kaplan-Meier method. Results Serum Tg decreased dramatically in 37/106 (34.9%) patients treated with131I. Thirty-nine of 61 patients (63.9%) with bone pain had pain relief. Age, tumor subtype and presence of non-osseous distant metastases were significant factors affecting 131I treatment efficacy based on serum Tg change (χ2=6.443, 11.455, 6.756, all P<0.05), but had no significant effects on bone pain palliation (χ2=0, 0, 0.060, all P>0.05). There were no imaging changes of bone metastases in 77.4% of patients after 131I treatment. The overall 5-year and 10-year survival rates from initial diagnosis of bone metastases was 86.47% and 57.90%, respectively. Univariate analysis showed that number of metastases, presence of non-osseous distant metastases and pre-131I treatment surgery were significant factors for survival (Log-rank values were 4.05, 5.98, 4.22, all P<0.05). Conclusions 131I treatment for bone metastases from DTC is effective for lowering serum Tg and palliation of bone pain. Single metastasis, absence of non-osseous distant metastases and pre-131I therapy surgery are favorable predictors of prognosis.