Objective To evaluate the effect ofJiawei-Danggui-Buxue decoction in the treatment for the patients with hemorrhagic anemia after total knee arthroplasty (TKA).Methods A total of 63 TKA patients with hemorrhagic anemia were included, and were divided into the treatment group (31 patients) and the control group (32 patients). All patients started to take medicine the second day after surgery. The control group took the Ferrous Succinate Tablets and the treatment group took Jiawei-Danggui-Buxue decoction in the following 4 weeks. The Hb and Hct were detected,and the changes of TCM syndrome scores and the total effect rates of anemiawere observed.Results The total effect rate of TCM syndrome scores in the treatment group was 93.54%, which was significantly higher than control group 83.87% (P<0.05); The total effect rate of anemia in the treatment group was 90.32%, which is significantly higher than control group 75.00% (P<0.05). At the fifteenth day after operation,. And at the postoperative 29th day, the levels of Hemoglobin (129.61 ± 13.02 g/Lvs. 113.35 ± 15.46 g/L,t=6.245) and Hematocrit (0.45% ± 0.03 %vs. 0.41% ± 0.04%,t=5.962) in the treatment group were significantly higher than those in the control group (P<0.05).Conclusions TheJiawei-Danggui-Buxue decoctionimprovethe Hb, HCT and the clinical effect rates of anemia and TCM syndromes for the patients with hemorrhagic anemia after TKA.

Objective To investigate the MRI features of intracranial solitary fibrous tumors/hemangiopericytomas (SFT/HPC),and to compare these findings with those of intracranial meningiomas.Methods The clinical features and MRI findings in 28 patients of intracranial SFT/HPC (SFT/HPC group)and 68 patients of meningiomas (meningiomas group) confirmed by operation and pathology were retrospectively analyzed.The indicators of two groups were compared.Results Shape of tumor,signal homogeneous,signal voids of vessel in tumor,hypointense signal nodules on T2WI and enhanded,cystic or necrosis in tumor,meningeal tail sign,changes of the nearby bone,sex,Ki-67％ level,blood lose in surgery had significant differences between SFT/HPC group and meningiomas group (all P＜0.05).Conclusion There are some differences between intracranial SFT/HPC and meningiomas.It is helpful in diagnosis and differential diagnosis through the comparative analysis of the imaging signs.

AIM: To discuss the single application on iris localization technology in excimer laser for the treatment of astigmatism.
METHODS:Totally 203 cases (406 eyes) of laser in situ keratomileusis ( LASIK ) in the treatment of compound myopic astigmatism patients were operated from November 2011 to November 2012 in our hospital. They were divided into two groups. One was observation group using iris localization and the other was control group using routine operation. Patients in the observation group of 100 cases ( 200 eyes ) , aged 18-43 years old, spherical diopter was - 1. 25 to - 8. 75D, astigmatism was -1. 0 to -3. 25D. In control group, 103 patients ( 206 eyes ) , aged 19-44 years old, spherical diopter was -1. 75-9. 50D, astigmatism was -1. 0 to -3. 25D. The patients in the observation group before the application of WaveScan aberrometer check for iris image, spherical lens, cylindrical lens and astigmatism axis data operation, only single application of iris location, without using wavefront aberration guided technology, laser cutting patterns for conventional LASIK model, spherical, cylindrical mirror and astigmatism axis  RESULTS: Postoperative residual astigmatism, the observation group was significantly better than the control group. Astigmatism axial measurement after operation, the observation group was significantly less than that of the control group. Postoperative visual acuity at 6mo, the observation group was better than that of the control group. The difference was statistically significant.
data source to preoperative wavefront aberration results. The control group received routine LASIK. It was applicated comprehensive optometry optometry respectively to examine astigmatism and axial, based on the computer analysis during the preoperative, 1wk after the operation, and 6mo. Analysis of using SPSS 17 statistical software, it was independent-sample t test between the two groups of residual astigmatism and astigmatism axis.
CONCLUSION: For patients who cannot complete the wavefront aberration guided treatment of astigmatism, can separate the application of wavefront aberration analyzer automatic iris recognition technology to improve precision of astigmatism treatment, give full play to advanced technical performance of equipment, which has good application value.

Objective To report a 33-year-old man with post-headache stroke-like episodes,with whom ischemic changes were found in basal ganglia and occipital-temporal lobe and muscle biopsy revealed abnormal mitochondrial structure and function without regular mutations detected in mtDNA.Methods Gene chip technique was used to detect the mutation of whole sequence of mtDNA,and direct sequencing technique was used to confirm the mutations.Results Three mutations were found.A new mutation in the mitochondrial cytochrome C oxidase subunit 1 (MTCO1),a T→C transition at nucleotide position 6253 resulted in conservative methionine transferring to threonine.His mother also held the mutation,which was not found in 98 control samples.So T6253C was considered the nosogenetic mutation.Conclusion This is the first time to report a mutation in MTCO1 responsible of MELAS.

OBJECTIVETo sum up the clinical experience in the management of benign prostatic hyperplasia (BPH) with the prostate weighing over 80 ml by transurethral resection of the prostate (TURP) combined with 2 μm continuous-wave laser vaporesection (LVR).

METHODSWe retrospectively analyzed the clinical effects of TURP combined with 2 μm LVR in the treatment of 46 cases of BPH with the prostate volume > 80 ml.

RESULTSAll the operations were successfully accomplished. The operation time and intraoperative blood loss were (112.0 ± 20.0) min (range 86-176 min) and (77.9 ± 25.9) ml (range 50-200 ml), respectively. The catheters were withdrawn at 7 days after surgery. Transient urinary incontinence occurred in 6 cases and secondary hemorrhage was found in 2 postoperatively. Six-month follow-up revealed no urethral stricture or other complications. Compared with the baseline, the international prostate symptom score (IPSS) was significantly decreased at 6 months after operation (26.3 ± 1.8 vs 11.6 ± 1.7, P <0.05), and so were the quality of life (QOL) score (5.3 ± 0.7 vs 1.3 ± 1.1, P <0.05) and post-void residual urine (PVR) ([115.5 ± 55.6] ml vs [19.9 ± 11.6] ml, P <0.05). However, the maximum urinary flow rate (Qmax) was remarkably increased from (4.1 ± 2.6) ml/s to (16.2 ± 1.7) ml/s (P <0.05).

CONCLUSIONTURP combined with 2 μm LVR is safe and effective for the treatment of BPH with the prostate volume >80 ml.

Aged ; Blood Loss, Surgical ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Organ Size ; Prostate ; pathology ; Prostatic Hyperplasia ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; methods ; Treatment Outcome ; Urethral Stricture ; Urinary Incontinence ; etiology ; Urinary Retention

OBJECTIVE: To investigate the effect of mycophenolate mofetil(MMF) on early inflammatory reaction of renal lesion in streptozotocin(STZ)-induced diabetic rats. METHODS: Thirty-six male Sprague-Dawley rats were randomly divided into 3 groups after uninephrectomy: normal control group, diabetic model group, and MMF-treated group. Six rats in each group were sacrificed at the 4th week and 14th week after STZ injection. Twenty-four hour urinary protein (24 h Upro) count was measured before death. The expressions of regulated on activation of normal T expressed and secreted (RANTES),ectodermal dysplasia (ED-1)and Col-IV protein in the renal tissue were detected by immunohistochemistry. The expression of RANTES mRNA in the renal tissue was detected by RT-PCR. RESULTS: MMF prevented the increasing of 24h Upro in diabetic rats,and the expressions of RANTES,ED-1,Col-IV protein and RANTES mRNA in the kidney of MMF-treated rats were significantly decreased. CONCLUSION MMF plays an early renal protective role in diabetic nephropathy, possibly through inhibition of early inflammatory reaction.
Animals ; Chemokine CCL5 ; biosynthesis ; genetics ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Diabetic Nephropathies ; metabolism ; prevention & control ; Ectodysplasins ; biosynthesis ; genetics ; Inflammation ; metabolism ; Kidney ; metabolism ; Male ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the efficacy of Disposcope endoscope(DE)-guided nasotrache-al intubation in patients with difficult airway by comparing with fiberoptic bronchoscope(FOB). Methods One hundred and twenty American Society of Anesthesiologists physical statusⅠ-Ⅲ patients of both se-xes, with body mass index<25 kg∕m2, aged 18-64 yr, with mouth opening<3 cm, of Mallampati classifi-cation Ⅲ or Ⅳ, undergoing maxillofacial surgery requiring nasotracheal intubation were divided into DE group(n=60)and FOB group(n=60)using a random number table.Nasotracheal intubation was per-formed under the guidance of DE or FOB after induction of anesthesia.Glottis exposure was evaluated using Cormack-Lehane grade.Epistaxis during intubation, successful intubation, time and degree of glottis expo-sure, intubation time and development of tachycardia and hypertension and requirement for assisted ventila-tion with face mask during intubation were recorded.The patients were followed up postoperatively, and the development of intubation-related complications was also recorded.Results Compared with group FOB, glottis exposure time and incubation time were significantly shortened(P<0.05), and no significant change was found in Cormack-Lehane grade, rate of successful incubation, rate of successful intubation at first attempt or intubation-related complications in group DE(P>0.05). Hypertension and tachycardia were not found and no patients required assisted ventilation with face mask during intubation in the two groups.Conclusion DE-guided nasotracheal intubation provides similar efficacy to that of FOB with shorter time and is an optimal selection for the patients with difficult airway.

OBJECTIVETo compare plasma and red blood cell folate levels among women in their first trimester of pregnancy from rural areas with high or low prevalence of neural tube defects.

METHODSA cross-sectional study was performed, among women in their first trimester of pregnancy from rural areas with high or low prevalence of neural tube defects in 2003. Non-fasting blood sample were collected and analyzed for plasma and red blood cell folate concentrations for 688 women.

RESULTSThe median plasma (10.53 nmol/L) and red blood cell folate (389.2 nmol/L) among women from the high prevalence rural area were lower than those of women from the low prevalence rural area (plasma folate: 30.39 nmol/L, red blood cell level folate: 926.0 nmol/L). Among women from the high prevalence area, about 50% and 43% were respectively, deficient for plasma and red blood cell folate, compared with 6% and 4% respectively, for women from the low prevalence area. The median plasma folate levels among women who took periconceptional folic acid supplements in both high and low prevalence areas were about twice higher than those who did not take the folic acid. The median red blood cell folate level of the folic acid users was 40% higher than those of the non-users. Among those who took folic acid, women in the low prevalence area had 70%-90% higher plasma folate concentration and twice higher red cell folate concentration than women in the high prevalence area.

CONCLUSIONWomen from the rural area with a high prevalence of neural tube defects had low plasma and red blood cell folate levels. Periconceptional supplementation with folic acid could substantially improve folate status of reproductive-aged women. However, supplementation with 0.4 mg of folic acid per day might be inadequate for women in the high prevalence rural area.

Dietary Supplements ; Erythrocytes ; chemistry ; Female ; Folic Acid ; administration & dosage ; blood ; Humans ; Neural Tube Defects ; epidemiology ; prevention & control ; Preconception Care ; Pregnancy ; Pregnancy Trimester, First ; Prevalence ; Rural Health

OBJECTIVETo analyze the clinical and pathological features of microscopic polyangiitis (MPA) to improve the diagnosis and treatment of the disease.

METHODSTwenty-five cases of MPA were retrospectively analyzed.

RESULTSThe onset symptoms of MPA, often nonspecific, included fever, muscle and joint pain, fatigue, loss of weight, etc, with varying degrees of proteinuria, hematuria and renal insufficiency. The pathological types revealed by renal biopsy were mainly focal segmental necrotizing glomerulonephritis or pauci-immune crescentic glomerulonephritis. Timely immunosuppressive therapy could improve the outcome.

CONCLUSIONThe early symptoms of MPA are often nonspecific to easily result in misdiagnosis. Examination of ANCA titers and timely renal biopsy are helpful to establish an early diagnosis. Immune suppression therapy and plasma exchange when necessary should be initiated after the establishment of the diagnosis. The disease activity and drug toxicity should be carefully monitored to improve the prognosis.

Adult ; Aged ; Female ; Humans ; Male ; Microscopic Polyangiitis ; diagnosis ; pathology ; therapy ; Middle Aged ; Prognosis ; Retrospective Studies

Objective To evaluate the strategy and management of cardiopulmonary bypass ( CPB) with cardiac surgery for pregnant women.Methods The clinical data of 4 pregnant women with severe cardiac diseases ,who received cardiac surgery with CPB in our hospital form January 2016 to June 2017 were retrospectively analyzed ,meanwhile the maternal and neonatal outcomes were reviewed also .Results Among 4 patient s,there were 1 case of subacute bacterial endocarditis ,2 cases of congenital heart disease complicated with subacute bacterial endocarditis,1 case of rheumatic heart disease.The New York Heart Association(NYHA) functional classification:there were 2 cases with class Ⅲand 2 cases with classⅣ.Operations included 2 mitral valve replacement and tricuspid valve plasty ,1 right coronary artery fistula re-pair and aortic valve replacement ,1 patent ductus arteriosus closure and mitral valve repalcement ,aortic valve replacememnt ,pulmonary valve replacement,tricuspid valve plasty.The CPB time ranged from 85 to 287 minutes(median 135 minutes),the aortic cross clamp time ranged from 52 to 178 minutes (median 89 minutes),the gestational age of pateints received cardia surgery ranged from 25 to 32 weeks(median 29 weeks).All patients were followed up for 1 to 16months(median 6 months),with no death;4 neonatal outcomes included 3 of full-term labor with cesarean section ,all of the 3 newborns were alive and no malformation ,1 of death in the uterus and spontaneous abortion at 2 days post-operative .Conclusion Cardiac surgery can be performed with relative safety during pregnancy .According to the physiological characteristics of pregnancy ,a reasonable CPB plan should be formulated pre-operative ,better maternal and fetal survival rates may be achieved by optimized management of CPB and used fetal mornitoring perioperative ,reduce the incidence of complications .