Objective To explore the etiology of patients with chief complaint of vertigo in the department of neurology in order to reduce thc rate of misdiagnosis.MethodsA total of 367 patients with chief complaint of vertigo in our department of neurology were followed up.The associated medical history,symptoms and physical examination were obtained.ResultsThe main diagnoses for the 367 patients were benign paroxysmal positional vertigo (BPPV) ( 219,59.7％ ),posterior circulation ischemia (PCI) ( 65,17.7％ ),migraine ( 31,8.4％ ),hypertension ( 18,4.9％ ) and psychogcnic vertigo ( 17,4.6％ ).Conclusions Presentation of vertigo can be clinically diagnosed in most discases,with the most common causc of BPPV.Combination of the prominent clinical features,physical examinations and especially Dix- Hallpike maneuver may guide the general physicians to a most proper cause of vertigo.

Calomel is a common traditional Chinese medicine (TCM) containing mercury in clinical external application. Although the toxicity of calomel has attracted concern, there is no unified standard yet in clinical external application. Risk assessment is used for evaluating the potential health effects of hazardous substances. The purpose of this article was to evaluate the health risk of calomel in clinical external application on the basis of toxicity data, to ensure safe and rational application of TCM containing calomel. The toxicity data of transdermal administration of calomel or mercurous chloride were collected by searching the literature. The daily maximum exposure dosage of calomel in clinical external application was estimated by following the four procedures of risk assessment, and Margin of Safety (MOS) as an evaluation indicator was then calculated to evaluate the safety of calomel on clinical application. It has been reported that the adult in single transdermal administration of calomel at 1. 5 g was lethal. Based on the LOAEL of calomel for long-term transdermal exposure (1 month) in rats was 0.096 g · kg(-1) · d(-1), the NOAEL of calomel for patients (about 60 kg) by external application within 2 weeks was estimated to be 1.46 mg · kg(-1) · d(-1). When MOS value equals to 1, the daily maximum exposure of calomel in clinical external application within 2 weeks was calculated to be 1.1 g. The results suggest that daily single dose of calomel in clinical external application should be lower than 1.5 g for adults, and more attention should be paid to changes in hepatic and renal function of patients when repeated dose more than 1.1 g within 2 weeks. The approach of risk assessment could be helpful in rational application of TCM containing mercury.
Animals ; Humans ; Medicine, Chinese Traditional ; Mercury Compounds ; toxicity ; No-Observed-Adverse-Effect Level ; Rats ; Risk Assessment

The origin of northern Artemisia argyi recorded in Compendium of Materia Medica(Bencao gangmu) is Fudao(Chinese characters) in Tangyin county, While there is only Fudao(Chinese characters) instead of Fudao(Chinese characters). Whether indeed Fudao(Chinese characters) is Fudao(Chinese characters)? By reviewing the genuine evolution of A. argyi, doing textual research on Fudao(Chinese characters) and combing with field survey data of national census of Chinese Materia Medica resources, this paper concluded that the word Fudao(Chinese characters) firstly emerged in Figure Canon of Chinese Materia Medica(Bencao tujing) of Susong in Song dynasty and was applied in later generations, but the implication was not clear, then emerged both Tangyin and Fudao(Chinese characters) in Compendium of Materia Medica(Bencao gangmu). The place Fudao(Chinese characters) is one of the graves of Bianque, that existed from Shang and Zhou dynasty and never changed until now, the A. argyi of Tangyin was famous from the grave of Bianque in Fudao(Chinese characters), which could infer that Lishizhen considered Fudao (Chinese characters) was Fudao(Chinese characters) indeed, and the origin of northern A. argyi was Fudao(Chinese characters) in Tangyin county.
Artemisia ; China ; Drugs, Chinese Herbal ; history ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 20th Century ; History, Medieval ; Humans ; Materia Medica ; history ; Plants, Medicinal ; Terminology as Topic

By using cup culture, influence of different strains (ammonium-resistant N2-fixing type, wild type, none N2-fixing type) of Klebsiella oxytoca on the growth of rice seedling was compared. It was discovered that ammonium-resistant N2 -fixing bacteria could excrete some plant growth promoting substance, which could be adsorbed by cation resin. It' s activity wouldn't be affected at 80℃. At optimal concentration, the weight of rice root and seedling were increased by

Objective To evaluate clinical and procedural characteristics and outcomes of patients with ST-elevation myocardial infarction(STEMI) caused by drug-eluting stent(DES) thrombosis undergoing primary percutaneous coronary intervention(PCI).Methods From October 2004 to June 2007,31 patients with STEMI due to definite DES thrombosis who received primary PCI were retrospectively studied(ST group).Baseline clinical,angiographic,PCI procedural features and 1-year outcomes were recorded.Another consecutive 93 patients with STEMI due to de novo coronary thrombosis were served as control group.The primary endpoint was cumulative rate of major adverse cardiac events(MACE),including death,reoccurrence of myocardial infarction and target vessel revascularization(TVR),during hospitalization and at 1-year follow-up.Results Compared with the control group,patients in ST group were older(69.9?11.4 y and 63.7?13.6 y,P=0.01) and higher comorbidity rates of diabetes(41.9% and 22.6%,P=0.04)and previous history of myocardial infarction(29.0% and 11.8%,P=0.02).The occurrence of TIMI 3 flow immediately after primary PCI was reduced(45.2% and 92.5%,P

Ring finger protein 43 (RNF43) is a ring-type E3 ubiquitin ligase.As a negative regulater of Wnt signaling pathway, RNF43 has an important anti-tumor effect.The mutation of RNF43 may cause abnormal activation of Wnt signaling pathway, and then promote invasion, metastasis and proliferation of tumor cell.In addition, the act of RNF43 protein in the Wnt signal pathway is expected to be a molecular target in the therapy of cancer.In recent years, with the gradual deepening of related research, the molecular structure of RNF43 protein and its mechanism of action with the Wnt pathway-related proteins have been gradually clear.In clinical, RNF43 protein analogs and related vaccine also show the important position in the therapy of cancer.

ObjectiveTo explore the effect of patients with acute cerebral infarction (ACI) at different ages receiving intravenous injection of alteplase for thrombolysis on their prognosis.Methods Ninety-eight ACI patients admitted to Jinghai Hospital of Tianjin from January 2014 to December 2015 were conducted in this study, and they were divided into elderly group (over 75 years old) and younger age group (under 50 years old). The patients in two groups of were given intravenous thrombolytic therapy with alteplase (0.9 mg/kg), 10% of the dose was intravenously injected, and continuously the remaining dose was pumped into the vein for 1 hour. Before the thrombolysis and 1 day and 21 days after thrombolysis, the score of United States National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits, the incidence of bleeding adverse event and mortality were recorded.Results Compared to the before thrombolysis, the NIHSS scores after thrombolysis on the 1st day and 21st day were significantly decreased in the two groups (the younger age group 1 day: 6±4 vs. 10±5, 21 days 2±2 vs. 10±5, the elderly group 1 day: 7±5 vs. 10±7, 21 days: 6±4 vs. 10±7, allP < 0.05), and NIHSS score in the younger age group was significantly lower than that in the elderly group on the 21st day after thrombolysis (2±2 vs. 6±4,P < 0.05). After thrombolysis, the incidence of minor mucocutaneous bleeding in elderly group was obviously higher than that in younger age group, the difference being statistically significant [7.69% (4/52) vs. 2.17% (1/46),P < 0.05]; the elderly group had higher symptomatic intracerebral hemorrhage and death events than those in younger age group [1 (1.92%) vs. 0].Conclusion Different ages of patients with ACI can benefit from intravenous thrombolysis with alteplase, showing the younger the age of the patients, the better the benefit they can get and have relatively better prognosis.

Objective To investigate the indications and results of combined liver-kidney transplantation.Methods From Jan. 2001 to Dec. 2003, 15 patients were subjected to combined liver-kidney transplantation in our department. The underlying diseases included hepatitis B viral cirrhosis complicated by HRS ( n= 8), hepatitis B viral cirrhosis complicated by uremia ( n =2), hepatitis B viral cirrhosis complicated by diabetic nephropathy ( n =1), polycystic liver and kidney disease ( n =2), Caroli's disease and polycystic kidney ( n =1), alcoholic liver cirrhosis complicated by uremia ( n =1). The surgical procedure, perioperative complications, acute and chronic rejection, the recurrence of hepatic viral B hepatitis, and the result of follow-up were analyzed.Results The graft function in 15 cases of combined liver-kidney transplantation was restored well after operation. The 6-month and one-year survival rate was 100%. One patient was supported by respiration machine for 48 days. The complications occurred in 3 patients after operation, including one case of gastroenternal bleeding repeatedly and one case of postoperative wound bleeding subject to non-surgical treatment, and one case of stenosis of biliary anastomosis subject to ERCP. Only one patient experienced a rejection episode of the liver. No acute rejection of the kidney graft occurred. One patient was died from liver graft function failure by recurrence of hepatitis B after 30 months.Conclusions Combined liver-kidney transplantation is only radical treatment method for patients with end-stage liver disease with chronic renal dysfunction or chronic renal failure. In the patients with hepatitis B,lamividine and hepatitis B immunoglobin can prevent the recurrence of hepatitis B.

[Objective]A prospective comparative evaluation of fulcrum bending radiographs(fulcrum)to determine curve flexibility and predict surgical correction in adolescent idiopathic scoliosis(AIS).[Method]A total of 64 consecutive patients with AlS according to inclusion and exclusion criterias who underwent surgical treatment were studied.All curve types were single-curve and the PUMC classification were Ia/Ib/Ic.All patients were divided into 4 groups according to the magnitude of Cobbs angle in preoperative standing anteroposterior radiograph:moderate thoracic curve(20 cases,40?60?),moderate lumbar curve(21cases,35?60?).The Cobbs angles were measured and the flexibility ratio was determined on fulcrum radiograph.The amount of correction obtained by fulcrum radiograph was compared with the amount of surgical correction by evaluating the differences from surgery as absolute values.The correlation of Cobbs angles between postoperative standing anteroposterior radiograph and fulcrum radiograph were analyzed.[Result]For the moderate thoracic curves,curve flexibility provided by fulcrum radiograph has no significant difference(P=0.141)from surgical curve correction,there was no significant difference(P=0.094)between the mean Cobbs angle on fulcrum bending and that on postoperative standing anteroposterior radiograph.The postoperative Cobbs angle was positively correlated with the preoperative Cobbs angle on fulcrum radiograph and the correlation degree in the moderate lumbar curve was relatively weak.[Conclusion]Fulcrum radiograph can only be used to assess the flexibility and correction of moderate thoracic curves in AIS.Pedicle screw instrumentation provides even more correction.