Adolescent ; Adult ; Aged ; Carbon-Nitrogen Ligases ; genetics ; Female ; Gene Expression ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Nasopharynx ; pathology ; Young Adult

OBJECTIVETo observe the clinical efficacy of Wangbi Tablet (WT) on the treatment of knee osteoarthritis (KOA), and to study its treatment program by integrative medicine.

METHODSThe randomized, parallel control, and multi-center clinical observation method was used. 160 KOA patients of Gan-Shen deficiency complicated with stasis-blood blockade syndrome were assigned to three groups. Group A (72 cases) was treated by WT, Group B (42 cases) was treated by Votalin Tablet, and Group C (46 cases) was treated by WT + Votalin Tablet. All patients were treated for two months. Before and after treatment the clinical symptoms, the knee function activity, adverse reactions were observed and recorded. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of each patient were respectively detected, statistically analyzed and compared.

RESULTSAfter eight weeks of treatment significant difference was shown in the time of morning stiffness in joints, joint tendemess, swelling, pain, joint functional activities, ESR, and CRP between Group A and Group B (P<0.01). Besides, better effects were obtained in Group C (P<0.01). Improvement of ESR and CRP: They were obviously improved in the three groups after treatment (P<0.01). As for the markedly effective rate, better effects were obtained in Group C (P<0.05).

CONCLUSIONSIn the treatment of KOA, WT showed favorable effects with no obvious adverse reaction. The combination of WT and Voltaren Tablet was significantly superior to use of WT or Votalin Tablet alone. It could reduce the dosage of Voltaren Tablet and avoid adverse reactions of the gastrointestinal tract.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Phytotherapy ; Tablets

OBJECTIVETo investigate the efficacy and mechanism of Fengshikang (FSK) in treating rheumatoid arthritis (RA).

METHODSThirty-eight patients with RA of damp-heat block syndrome type in Chinese medicine (CM), were randomized into two groups. They all received glucocorticoid therapy for 1 month, but FSK was administered to the 20 patients in the CM group in addition, while to the 18 in the WM group, MTX was given. Besides, a normal control group with 20 healthy subjects was set up. Blood levels of RA related indices were measured and compared.

RESULTSAfter treatment, the levels of rheumatoid factor (RF) and C-reactive protein (CRP) were significantly reduced in both groups (P<0.05), but the reduction was more significant in the CM group (P<0.05). No significant change was found in the level of ESR after treatment and showed no significant difference between groups (P>0.05). Both hGRalpha mRNA and hGRbeta mRNA expressions were significantly higher in the patients than in the normal controls (P<0.01), they were lowered after treatment in the CM group (P<0.01), but significant reduction could only be found in level of hGRbeta mRNA in the control group (P<0.01).

CONCLUSIONFSK combined with glucocorticoid can effectively control the inflammatory reaction, decrease the level of hGRalpha and hGRbeta expressions and enhance the clinical efficacy in treating RA.

Adult ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Middle Aged ; Phytotherapy ; RNA, Messenger ; genetics ; metabolism ; Receptors, Glucocorticoid ; genetics ; metabolism ; Young Adult

The RNA-directed DNA Methylation (RdDM) is one type of epigenetic modification which was firstly discovered in plant. RdDM can directly cause DNA modifications of the genome through RNA-DNA interactions. In plant, both of RdDM and mRNA degradation induced by siRNA can silence sequence specific genes through RNA. They play very significant roles in chromosome rearrangement, defence of virus invasion, regulation of gene expression and many processes of plant development. However, the mechanisms of RdDM are still unclear. In this paper the basic characteristics of RdDM were briefly summarized and advances in studies on mechanisms of RdDM were reviewed. These include the kinds of DNA methyltransferases and their functional mechanisms in RdDM, the relationships between DNA methylation and chromatin modification, and important proteins involved in the RdDM process. In plants, RdDM may occur at both the transcriptional and post-transcriptionnal levels, both of which induce gene silencing. Methylation of the target gene promoter correlates with transcriptional gene silencing (TGS) whereas methylation of the coding sequence is associated with post-transcriptional gene silencing (PTGS). RdDM and RNAi all depend on the similar siRNA and enzymes, such as DCL3, RdR2, SDE4 and AGO4. There are at least three kinds of DNA methyltransferases, DRM1/2, MET1 and CMT3, in pants. They can interact with and modifies all cytidines within the DNA regions homologous to RNA sequence. Furthermore, methylation of lysine 9 in Histone H3 can affect the methylation of cytidines.
DNA Methylation ; DNA Modification Methylases ; metabolism ; Gene Silencing ; Plants ; genetics ; metabolism ; Protein Processing, Post-Translational ; RNA ; metabolism

OBJECTIVETo observe the effect of octyl-a-cyanoacrylate upon bone healing and its degradation in vitro after middle tibial transverse fracture in rabbitsì and to establish treatment of higher efficacy with the application of octyl-a-cyanoacrylate.

METHODSMiddle tibial transverse fracture model of New Zealand rabbits was established. In the experimental group, internal fixation with 2 mm Kirschner wires was performed and the broken ends were fixed with octyl-a-cyanoacrylate. In the control group, only internal fixation with 2 mm Kirschner wires was conducted. Animals were killed at preset time intervals of 2, 4, 6, 8, 10 and 12 weeks postoperatively and samples were harvested.

RESULTSTwo weeks after operation, clear fracture lines were observed in both the experimental and the control groups. Fibrous soft tissue connection was noted between the broken ends and there was soft tissue adhesion around the fracture site. There was no callus formation and the broken ends were surrounded by adhesive soft tissues. Obvious external callus formation was confirmed at 8 weeks after operation in both groups with partial disappearance of fracture lines. Ten and twelve weeks after the operation, fracture lines disappeared completely and there was obvious external callus formation and bone union. In the fourth week, fibrous cells and chondrocytes were found to grow into the colloid and surround it at the 6th week. The adhesive material was degraded and gradually absorbed at the 8th week. Chondrification was observed.

CONCLUSIONSTwo weeks after fixation for tibial fracture in rabbits, octyl-a-cyanoacrylate begins in vivo degradation. Chondrocytes and fibrocytes gradually grow into the degradation area and surround the adhesive material, which broke into pieces at 8 weeks. Complete degradation and disappearance of the adhesive material is present between 10 and 12 weeks. No barrier effect hampering fracture healing is noted.

Adhesives ; therapeutic use ; Animals ; Cyanoacrylates ; therapeutic use ; Rabbits ; Radiography ; Tibial Fractures ; diagnostic imaging ; pathology ; therapy

Objective To explore the significance of designing with monitoring-flap in massive com- pound bone grafts for repairing massive bone defects in extremities.Methods From January 2001 to De- cember 2004,large bone defects in 19 patients(11 men and 8 women,age:6 to 35 years,mean age:18.6 years)were repaired by vascularized free fibular transplant with a monitoring-flap combining with massive deep frozen bone allografts.Average length of the bone defects was 16.6 cm(range,12 to 25 cm).A 7 days' con- tinuously clinical examination including observing the color,turgor,temperature,capillary refill,and bleeding after a needle sticking of the monitoring-falps were used postoperatively,if any one of these were abnormal,the circulation of the compound bone grafts must be in danger and some measures such as re-operation should be taken immediately.Dynamic image analysis was used for evaluating the bone union.Results One monito- ring-flap was vascular artieulo,and the articulo was relieved after exploration and resection of vein thrombus; another one was marginal part necrosis;the remains were normal.All of monitoring-flaps healed normally after 23.2 months(range,6 to 54 months)follow-up.15 patients had the radiographic evidence of bone unions 3 months after surgery.11 patients had been removed intermal fixation,complete bone unios were found one year postoperatively.Conclusion Designing with monitoring-flap in massive compound bone grafts for repairing massive bone defects,and can clearly understand the circulatory statue of compound bone grafts and early pre- dict the final results of massive bone allografts.

Objective: To investigate the changes of myo cardial contractile function during myocardial stunning in calcium overload rats and the protective effects of tetrandrine. Methods: Forty-six rats were randomized into control, myocardial ischemia, myocardial stunning, low and high dose of tetrandrine groups. Another 10 rats were used to identify the calcium overload. vitamin D3 (0.3 million Unit/kg) and nicotinic acid were adm inistered. After 16 d when calcium overload occured, left anterior descending ar tery was ligated. Twenty minutes of myocardial ischemia followed by 60 min of re perfusion was induced. The contractile function parameters were determined dynam ically. At the end of experiment, myocardial cytosolic ［Ca2+］i was deter mined in various groups. In tetrandrine groups, tetrandrine (62.2 or 93.6 μmol/ kg ) was administered by gastrogavage daily.After 16 d, the rats undergone the e xperiments mentioned above. Results: Sixteen days after vitamin D3 , nicotinic acid were given, ［Ca2+］i increased by 2.6 folds (146.8±10.8 ) vs (368.5±22.6) nmol/L, (P<0.01). Whereas, ［Ca2+］i in tetrand rine groups were (210.8±16.4) and (198.6±15.3) nmol/L, which were significantl y lower than that of calcium overload group. Twenty minutes of myocardial ische mia resulted in the decrease of dp/dtmax and Vmax in all groups with the most si gnificant in stunning and calcium overload groups. The contractile function rest ored gradually after reperfusion. At all time points, dp/dtmax and Vmax in both tetrandrine groups were higher than those in both stunning and calcium overload groups. And effect with higher dose of tetrandrine were more significant than in low dose of tetrandrine. After 60 min of reperfusion, dp/dtmax in stunning, cal cium overload, low and high dose of tetrandrine groups were 49.7%, 51.5%, 71.0% and 83.4% of that in control, respectively， and Vmax were 55.0%, 49.8%, 73.9% and 77.5% of that in control, respectively. Conclusion: T he myocardial contractile function in vitamin D3-induced calcium overload gro up is impaired. On basis of myocardiocyte calcium overload, transient ischemia l eads to myocardial stunning. At the stage of ischemia, the impaired degree of my ocardial contractile function is similar to that in stunning group, suggesting a t this stage the effect of ischemia on myocardial function is greater than that of calcium overload. Tetrandrine chronically improves the myocardial function in Vitamin D3-induced calcium overload rats.

OBJECTIVETo retrospectively analyze the medical treatment of 332 patients with lower leg fracture in Wenchuan earthquake admitted in West China Hospital.

METHODSFrom May 12, 2008 to June 15, 2008, 332 patients with lower leg fracture injured in Wenchuan earthquake were treated in our hospital. The data on trauma condition and clinical treatment were collected and analyzed.

RESULTSAmong the 332 cases of lower leg fracture, there were 179 cases of open fracture, accounting for 53.9%, in which 91% belonged to Gustilo II or III injury with serious pollution. Many patients had posttraumatic complications, vascular and nerve injury, wound infection or osteofascial compartment syndrome. After medical treatment, blood vessels were reconnected, wound surface was repaired and wound infection was under control.

CONCLUSIONFor the patients with lower leg fracture in earthquake, we followed the principle of "complete debridement - restoring the continuity of bone bracket-timely recovering blood supply of limbs and repairing nerve damage - repair the wound surface at stage I or II " so as to reduce the incidence of amputation and infection.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Compartment Syndromes ; etiology ; Earthquakes ; Female ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Leg ; blood supply ; innervation ; Leg Injuries ; surgery ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo evaluate the surgical techniques for acute left deep venous thrombosis (LDVT) secondary to left iliac vein compression syndrome (IVCS).

METHODSThirty-six patients with acute LDVT secondary to IVCS received inferior vena cava filter placement, and in 2 of the cases, stent implantation was canceled for acute episode of obsolete DVT. The remaining 34 patients underwent left femoral venotomy for iliofemoral thrombectomy with Fogarty catheter and distal femoral vein thrombus removal by sequential compression of the legs, followed by implantation of stent-graft (2 cases) or bare-metal stents (32 cases) in the left common iliac veins. With routine anticoagulation and thrombolytic treatments, the patients were regularly examined for postoperative blood flow in the affected limb.

RESULTSIn 2 of the cases undergoing bare-metal stent implantation, the residue thrombi were squeezed into the stent by balloon, which was managed subsequently with local thrombolysis. One patient with bare-metal stent implantation received a secondary stenting for posterior stent displacement. Three patients had self-limited bleeding due to decreased serum FBG. Significant improvements were achieved at 3, 6, 30 and 180 days postoperatively in the circumferences of the affected limb (P<0.05) and in the levels of D-dimer (P=0.011), and FBG level showed no significant variations (F=1.163, P=0.345). The total rate of excellent outcomes was 83.3% (26/34) with a total effective rate of 91.2% (31/34) in these cases.

CONCLUSIONSThrombectomy to revascularize the inflow tract and stent implantation to enlarge stenosed iliac veins are key issues in treatment of acute LDVT secondary to IVCS.

Femoral Vein ; surgery ; Humans ; Leg ; pathology ; May-Thurner Syndrome ; complications ; surgery ; Stents ; Thrombectomy ; Vascular Grafting ; Venous Thrombosis ; etiology ; surgery

OBJECTIVETo investigate the effect of allogeneic leukocyte immunization combined with in vitro fertilization-embryo transfer (IVF-ET) for treatment of infertility induced by habitual abortion.

METHODSAllogeneic leukocyte immunization was performed in 9 patients with infertility induced by habitual abortion, with another 9 patients undergoing IVF-ET without habitual abortion as the control group. All the patients were treated with long GnRH-a protocols. The infertility patients with recurrent spontaneous abortion history were immunized with lymphocytes from the husband for before IVF-ET and after clinical pregnancy.

RESULTSThe fertilization rates of the immunotherapy group and control group were 81.3% and 82.2%, respectively, showing no significant difference (P>0.05). Five patients in each group had clinical pregnancy, and a twin pregnancy occurred in the control group. The embryo implantation rates were also comparable between the two groups (22.7% vs 28.6%, P>0.05). All the fetuses resulted from IVF-ET developed normally and were healthily delivered.

CONCLUSIONAllogeneic leukocyte immunotherapy along with IVF-ET is effective for treatment of infertility resulting from recurrent spontaneous abortion.

Abortion, Habitual ; physiopathology ; Adoptive Transfer ; methods ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Humans ; Infertility, Female ; physiopathology ; therapy ; Pregnancy ; Pregnancy Outcome ; Treatment Outcome