Objective To investigate the allergic reaction of Shuanghuanglian Injection(SI)and chlorogenic acid.Meth- ods The sensitization of SI was evaluated by observed the systemic active allergic reaction on guinea pigs.The homogeneous and heterogenic passive skin allergic reactions in rats,mice and guinea pigs were observed to compare the sensitationz of SI and chlorogenic acid.Results The possibility of SI causing allergic reaction was higher than that of chlorogenic acid.Con- clusion It is suggested that the possibility of SI as a compound arising adverse reactions be higher than that of chlorogenic acid.

Child ; Epiphyses ; Fracture Fixation, Internal ; Humans ; Lower Extremity

OBJECTIVETo evaluate computed tomography (CT) and magnetic resonance imaging (MRI) findings in patients with autoimmune pancreatitis (AIP).

METHODSThe imaging findings of pancreas and extra-pancreas in 24 patients with AIP were retrospectively reviewed. Among them, CT scan was performed in 18 patients, MRI in 11, and bGth CT and MRI in 10.

RESULTSThe pancreas showed diffuse enlargement (25%, 6/24), focal enlargement (37. 5%, 9/24), combined enlargement (25%, 6/24) ,and no enlargement (12. 5%, 9/24). Unenhanced CT showed hypoattenuation in AIP area (n = 2) . After intravenous injection of contrast medium, 17 patients showed abnormal contrast enhancement in the affected pancreatic parenchyma, including hypoattenuation during the arterial phase (50%, 9/18) and hyper attenuation during the delayed phase (94. 4%, 17/18). Precontrast MRI showed abnormal signal intense (n =9), including hypointense on T1-weight images (T1 WI) (n = 7), hyperintense (n = 7) and hypointense (n = 2) on T2-weight images (TIWI). Enhanced MRI demonstrated abnormal contrast enhancement within lesions (n = 11), including hypoattenuation during the arterial phase (81. 8%, 9/11) and good enhancement during the delayed phase (100%, 11111). A capsule-like rim was seen around pancreas (37. 5%, 9/24), among which CT detected in 6 out of 18 patients and MRI found in 7 out of 11 patients.The main pancreatic duct lumen within lesions has no visualization (100%, 24/24) and upstream dilation of the main pancreatic duct (n = 8) , ranging from 2. 2 to 4. 5 mm(mean 3. 1 0. 47 mm) in diameter. Narrowing of the common bile duct was shown in 14 patients. Miscellaneous findings were: infiltration of extrapancreatic vein (n = 9) and artery (n = 1); mild fluid collection around pancreas (n = 2); pseudocysts (n = 3). Fourteen patients also presented one or more of the following extrapancreatic imaging findings: narrowing of the intra-hepatic bile duct or hilar duct (n = 5); thickening of gallbladder wall (n = 5); fibrosis in mesenteric (n = 2), in retroperitoneal (n = 2) and in ligamentum teres hepatis (n = 1); renal involvement (n = 3); peri-pancreatic or para-aortic lymphadenopathy (n = 10); and ulcerative colitis (n = 3).

CONCLUSIONAIP display some characteristic CT and MRI imaging features: sausage-like change of the pancreas; capsule-like rims around lesions; delayed contrast enhancement in the affected pancreatic parenchyma; segment or diffuse pancreatic duct stenosis but mild upstream dilation and extrapancreatic organs involvement. CT and MRI findings combining with serological tests and pancreas biopsy can assist physicians to make accurate and timely diagnosis.

Adult ; Aged ; Autoimmune Diseases ; diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreas ; diagnostic imaging ; pathology ; Pancreatitis ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To compare the efficiency and safety of aspirin-dipyridamole and warfarin in the prevention of thromboembolism in patients with nonvalvular atrial fibrillation(NVAF)and high risk factors.Methods One hundred and forty NVAF patients with high risk factors were randomly divided into two groups.Warfarin group[78 cases international normalized ratio(INR)2.0-3.0,for the patients older than 75 years,INR ranging from 1.6 to 2.5]and combination group(62 cases received aspirin 160 mg once every day plus dipyridamole 160 mg 3 times every day).The incidence of death,thromboembolism(including stroke and peripheral arteries embolism)and hemorrhage events were observed.Results Followed-up 12-28 months.In warfarin group,3 cases lost,2 cages had stroke,2 cases suffered from serious bleeding events,6 cases had minor bleeding events.In combination group,2 cases lost,6 cases had stroke,and 2 cases suffered from peripheral arteries embolism events,3 cases had minor bleeding events,but no serious bleeding events occurred.The incidence of thromboembolism in warfarin group wag,lower than that in combination group[2.7%(2/75)vs 13.3%(8/60),P<0.05].There was no significant difference of the bleeding rate between the two groups[10.7%(8/75)vs 5.0%(3/60),P>0.05].Conclusions Warfarin anticoagulative therapy is more effective than aspirin and dipyridamole antiplatelet dual therapy for the prevention of thromboembolism events in patients with NVAF and high risk factors.The major bleeding events in warfarin group occurs in patients with INR>3.0,so under intensive monitoring(INR 2.0-3.0),warfarin therapy is effective and safety.

BACKGROUND: Progress of lung infection after kidney transplantation is rapid, and the adjustment of immunosuppressive drugs is critical, which related to the prognosis of pneumonia and the maintenance of renal function. Therefore, an accurate diagnosis for the pneumonitis post-kidney transplantation is of great significance for choosing the appropriate treatment scheme. OBJECTIVE: To summarize the diagnosis and treatment of pulmonary infection at different periods after kidney transplantation, and then to explore the proper treatment scheme. METHODS: A retrospective analysis of 178 cases of pulmonary infection at different periods after kidney transplantation was performed. According to the progress of patients with lung inflammation, the lung infection was divided into three phases: early, advanced, and phases, and then given different immunosuppressive treatments combined with glucocorticoids; for those with unclear pathogens, given broad-spectrum antibiotics, antiviral, anti-fungal and other drugs, and targeted anti-infective treatment was underwent once pathogen was confirmed. RESULTS AND CONCLUSION: (1) There were 178 patients with pulmonary infection after kidney transplantation, 90 cases occurred at postoperative 1-6 months (78 cases at postoperative 2-4 months), 16 cases occurred at postoperative 6-12 months, 14 cases occurred at postoperative 12-24 months, 12 cases occurred at postoperative 24-36 months, and 46 cases occurred at postoperative more than 36 months. (2) The clinical symptoms of pulmonary infection at the early stage were not obvious, fever was the earliest or primary symptom, and sometimes it was the only symptom. In some cases, the patients appeared with dry cough, expectoration with white mucous sputum, and the amount of sputum increased if infected with mixed bacteria or fungus. But the pulmonary signs are unobvious, and the main imageology feature of lung tissues showed interstitial inflammation. (3) Totally 173 patients were cured, the recovery rate reached to 97.2% and the curative efficacy was satisfactory. (4) Among five patients who dead from pulmonary infection, three were died from acute respiratory failure, and two were for multiple organ failure. Three patients presented with acute rejection to transplant kidney and were cured, and six patients suffered impaired renal function. (5) These results suggest that there is potential risk for pulmonary infection after renal transplantation and it develops rapidly. Based on the situation of pulmonary infection, the physicians can adjust the dose of immunosuppressor and hormone in time, so as to improve the immunosuppressive state and clarify the pathogen for pulmonary infection, then corresponding treatment for anti-infection will be offered, which is beneficial to increase the recovery rate of pulmonary infection and improve the stability of transplanted renal functions.

Objective To analyze the outcomes of the surgery repair for total anomalous pulmonary venous connection(TAPVC),and to investigate the risk factors which influence the mortality of the operation.Methods Comparative analysis was performed in the children with TAPVC who were treated operatively from Sep.2001 to Sep.2011 in the Third Affiliated Hospital of Zhengzhou University,Henan Diagnosis & Treatment Center of Congenital Heart Disease.The children included 37 male and 20 female,aged from 15 days to 6.5 years[(4.27 ± 8.63) months],with body weight 4.0-21.0 (6.33 ± 2.70) kg,and the clinical records in hospital including echocardiogram operation records were collected.The clinical data including the age on operation,body weight,diagnosis,anatomic type of TAPVC,the emergency event before operation,cardiopulmonary bypass time,aortic crossclamping time,were analyzed by chisquared test and Logistic multivariable regression analysis.The risk factors influencing the early mortality of TAPVC were analyzed.Results Fifty-seven children underwent the operation,and 7 (12.2％)cases died during the operation.The univariate analysis on outcomes indicated that the risk factors influencing the mortality of the operation included body weight(P =0.035),anatomic type of TAPVC (P =0.037),the emergency event before operation (P =0.021),and aortic crossclamping time(P =0.046).The Logistic multivariable regression analysis indicated that the emergency events before operation was the independent risk factor for the mortality of TAPVC(P =0.003).Conclusion TAPVC children with preoperative emergency events have higher postoperative mortality.

BACKGROUNDThe subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study.

METHODSTotally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period.

RESULTSAll 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 (68%) patients, subtotal resection in 7 (28%) patients, and partial resection in 1 (4%) patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit (64%). Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference.

CONCLUSIONSModified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Meningioma ; pathology ; surgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Young Adult

·AIM: To study the clinical effect of Conbercept and Ranibizumab for macular edema ( ME ) with meta -analysis.·METHODS:We searched Pubmed, EMBASE, Cochrane Library Central Register of Controlled Trials ( CENTRAL) , Google scholar, ClinicalTrials. gov, CNKI, VIP and wanfang database for studies which published between January 12012 and July 12017, on the comparison of conbercept with ranibizumab for the clinical effect of secondary macular edema. The primary endpoints were visual acuity ( VA ) and central macular thickness in this study to assess the efficiency of the drugs. Review Manager 5. 3 and Stata 12. 0 were used for data analysis with the pooled odds ratios (OR), mean difference and 95% confidence interval ( CI) .·RESULTS: Eleven RCTs involving 812 patients met inclusion criteria and included in this meta-analysis, including 414 eyes in conbercept group and 398 eyes in ranibizumab group. Macular edema in this study were secondary to age-related macular degeneration, diabetic retinopathy and retinal vein occlusion. No significant differences in improvement of vision acuity(P=0. 09) or reduction of CMT (P>0. 05) were noted at the end of 3mo between two groups. Compared to ranibizumab, conbercept showed a better effectiveness in macular edema alleviation in the end of 6mo in the present study (OR=-58. 50, 95%CI: -108. 04 to -8. 95;P=0. 02).· CONCLUSION: Despite evidence from the meta -analysis of the RCTs suggesting a strong difference of the effectiveness for macular edema between conbercept and ranibizumab, more clinical trials are still needed to confirm our results because of the heterogeneity in the collected data.

OBJECTIVETo explore the effects of brain-derived neurotrophic factor (BDNF) pretreatment on beta amyloid protein (Abeta) induced impairment of in vivo hippocampal long-term potentiation (LTP) in the CA1 region of rats.

METHODSThirty-six adult male SD rats were randomly divided into six groups (n = 6): control, Abeta25-35, BDNF, (0.02 microg, 0.1 microg, 0.5 microg) BDNF + Abeta25-35. A self-made hippocampal local drug delivery catheter and a parallel bound stimulating/recording electrode were used to deliver drugs/stimulation and record field excitatory post-synaptic potentials (fEPSPs) in the hippocampal CA1 region of rats. High-frequency stimulation (HFS) was used to induce in vivo LTP.

RESULTS(1) Abeta25-35 (2 nmol) injection into CA1 region of rats did not affect the baseline fEPSPs, but inhibited the HFS-induced LTP significantly (P < 0.01). (2) Hippocampal CA1 injection of BDNF (0.1 microg) alone did not affect the baseline fEPSPs and HFS-induced LTP. (3) Compared with Abeta25-35 alone group, the averaged amplitude of LTP in BDNF (0.1 microg and 0.5 microg) plus Abeta25-35 groups significantly increased at 0 min, 30 min, and 60 min after HFS (P < 0.01), indicating that pretreatment with BDNF effectively protected against the Abeta,25-35 induced depression of LTP in a dose-dependent manner.

CONCLUSIONIntrahippocampal injection of BDNF can protect against the Abeta25-35-induced LTP impairment, suggesting that the up-regulation of BDNF in the brain could maintain the normal hippocampal synaptic plasticity and may contribute to the improvement of learning and memory in Alzheimer's (AD) disease patients.

Amyloid beta-Peptides ; antagonists & inhibitors ; Animals ; Brain-Derived Neurotrophic Factor ; pharmacology ; CA1 Region, Hippocampal ; drug effects ; physiology ; Excitatory Postsynaptic Potentials ; physiology ; Long-Term Potentiation ; physiology ; Male ; Peptide Fragments ; antagonists & inhibitors ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the risk factors related to the survival rate, recurrence and metastasis of malignant fibrous histiocytoma of bone.

METHODSFrom July 1997 and July 2010, 56 patients with malignant fibrous histiocytoma of bone were treated. Univariate and multivariate analysis were performed to determine the probable risk factors including gender, age, tumor location, tumor size and so on.

RESULTSForty-four cases were followed up ranged from 2 weeks to 78 months (medium 33.3). The 5-year overall survival rate was 50.1%, local recurrence rate 40.9% with a median time of 12 months (3 to 60 months) and metastatic rate 27.5% (11/40) with a median time of 6.5 months (2 to 23 months). Univariate analysis indicated that gender, condition of presentation (primary case or recurrence case), tumor location, surgical margin and surgical stage were significantly related to survival rate (P < 0.05), and tumor location and surgical margin were related to local recurrence rate (P < 0.05), and important vessel or nerve invasion was related to metastatic rate (P < 0.05). Multivariate analysis showed that surgical margin and surgical stage were independent risk factors for survival rate, of which surgical margin was the independent risk factor for recurrence rate.

CONCLUSIONSSurgical margin and surgical stage are independent risk factors for survival rate, of which surgical margin is the independent risk factor for recurrence rate.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; diagnosis ; pathology ; Female ; Histiocytoma, Malignant Fibrous ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; pathology ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult