Adult ; Female ; Humans ; Middle Aged ; Posture ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sedentary Lifestyle ; Surveys and Questionnaires ; Work ; Young Adult

Lycii Cortex, a popular herb medicine in traditional Chinese medicine, is used to treat different inflammation-related diseases. The aim of our work is to find the key constituents inhibiting NF-kappaB, a key regulator of inflammation. In the investigations of cell-based in vitro assays of extracts, we found that both ethyl acetate extract and methanol extract of Lycii Cortex inhibited the TNF-alpha-induced activation of NF-kappaB. Through bioassay-guided fractionation, we identified 4 phenolic amides including trans-N-(p-coumaroyl) tyramine (1), trans-N-feruloyltyramine (2), trans-N-caffeoyltyramine (3), and dihydro-N-caffeoyltyramine (4). Four phenolic amides showed differently inhibitory activities on TNF-alpha-induced NF-kappaB activation. Trans-N-caffeoyltyramine (3) was identified as the key component with an IC50 of 18.41 micromol x L(-1). It was suggested that the hydroxyl group at C-3 in trans-N-caffeoyltyramine might be a key binding site and its C-7,8-double bond might play an important role on NF-kappaB inhibitory activities as the link of the conjugation of pi electrons leading to a partial planar conformation. It might be inferred that the biological activity of compound 3 is attributed to the structure of Michael reaction acceptor containing alpha, beta-unsaturated ketones and benzene along with hydroxyl group in o-diphenol.
Biological Assay ; Cell Line ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; Inflammation Mediators ; antagonists & inhibitors ; immunology ; Lycium ; chemistry ; Molecular Structure ; NF-kappa B ; antagonists & inhibitors ; immunology

Objective To report a case of foot hyalohyphomycosis due to Fusarium subglutinans. Methods Medical history was collected and physical examination performed for this patient.Biopsy samples were obtained from the inner side of right ankle of this patient and subjected to pathological examination. Discharge was collected from the lesions for direct microscopic examination and culture.Results A 72-year-old woman presented with an ulcer on the right foot for 3 years.Physical examination disclosed an ulcer,measuring 3 cm x 1.5 cm,with a moist surface and obvious tenderness,at the inner side of the right ankle.Proliferation of dusky-red granulomatous tissue was observed at the base of the ulcer.Pathological examination revealed necrotic granulomatous tissue and slender,septate and hyaline hypha-like structure in the superficial dermis with scattered infiltration of inflammatory cells.PAS staining showed sausage-like hypha and scattered orbicular-ovate spores.Microscopic examination of lesional discharge exhibited septate, branching and hyaline hypha.The isolated fungus was identified as Fusarium subglutinans by culture,and appeared to be highly sensitive to terbinafine,nystatin and amphotericin B.The lesion completely healed after 2 months of treatment with oral terbinafine (0.25 g,twice a day).Conclusions This is a case of foot hyalohyphomycosis due to Fusarium subglutinans,and terbinafine is effective for this condition.

Objective To study the current situation of emergency nurses' structural empowerment,competency,job satisfaction,and their correlative factors.Methods Literature review, interview and questionnaire were used to establish the emergency nurses' structural empowerment and competency model.300emergency nurses were structurally empowered,and their quality of care and job satisfaction was compared before and after.Results The quality of care and job satisfaction after structural empowerment was (98.45 ±1.36) and (98.19 ± 2.63 ),both of which were higher than that before structural empowerment (95.33 ±2.47) and (93.81 ± 4.54),and the differences were statistically significant (t =-4.468,16.136,respectively; P ＜ 0.05).After structural empowerment,there was great improvement in emergency nurses' selfevaluation,as well as their ability of critical thinking,receiving information,communication and health education,while there was little improvement in their ability of social support,logical reasoning and innovation.Conclusions Establishing structural empowerment and competency model for emergency nurses helps them position themselves and promote their development,as well as provides reference to select and train professional nurses for hospitals.

BACKGROUNDIntractable secondary glaucoma with severe ocular contusion involving the posterior segment is difficult to treat. In this study, we evaluated the safety and efficacy of combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment.

METHODSThis retrospective interventional study enrolled 18 eyes from 18 consecutive cases with uncontrolled intraocular pressure, angle recession exceeding 180°, dense vitreous hemorrhage, and/or limited retinal detachment after severe ocular contusion. Combined trabeculectomy and vitrectomy was performed after giving the patient sufficient anti-inflammatory and intraocular pressure (IOP)-lowering medication. Follow-up averaged 26.2 (range, 6.0- 48.0) months.

RESULTSThe mean IOP decreased from (36.4 ± 10.0) mmHg on maximum IOP-lowering medications to (14.6 ± 4.4) mmHg on (0.7 ± 1.2) topical medications at the final follow-up (P < 0.0001). During the first postoperative month, four eyes (22%) had a short hypertensive phase and six eyes (33%) had early hypotony, including one case (5.6%) of bleb leakage. Seven eyes (39%) developed recurrent hypertension 3- 6 months postoperatively, five of which were controlled by topical medications. Ten (55.6%) eyes were classified as a complete success, five (27.8%) as a qualified success, and three eyes (16.7%) as failures. Kaplan-Meier survival analysis for complete and cumulative success showed 53.5% and 80.0% survival at 48 months, respectively. Visual acuity was improved in 15 eyes (83.3%). Three eyes (16.7%) had unchanged visual acuity, one (5.6%) of which developed atrophia bulbi despite a normal intraocular pressure. No recurrent retinal detachment or vitreous hemorrhage developed.

CONCLUSIONCombined trabeculectomy and vitrectomy is a viable surgical procedure for the management of intractable glaucoma with severe ocular contusion involving the posterior segment in selected cases.

Adult ; Aged ; Female ; Glaucoma ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; physiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Retrospective Studies ; Trabeculectomy ; methods ; Vitrectomy ; methods

AIMStudy on the relationship between the degraded spinal cord injuries and the changes of the motor evoked potentials (MEP) to prove the diagnosis and prognosis value of MEP.

METHODSAfter injury at T8-T9 cord using modified Allen's weight-drop method, 27 male SD rats were divided randomly into control group (n = 5), group A (50 gcf, n = 8), group B (70 gcf, n = 8) and group C (100 gcf, n = 6). MEPs elicited by monopolar transcortical stimulation were recorded continuously before injury, just after injury, 15 minutes, 1 hour, 3 hours and 6 hours after injury. The rate of the size of the bleeding or necrosis area to the total cord was also calculated.

RESULTSMEP had no significant change in the control group. The amplitude of MEP's early components in group A or group B decreased or even obliterated after SCI, and then partially recovered, while the late components were lost without any recovery signals. All animals in group C showed no MEP waves excepting 2 rats had recovery signals. The size of the cord injuries area increased according to the dropping force and was correlated significantly with the amplitude of the largest peaks of scMEP 1 hour after SCI (r = -0.821).

CONCLUSIONThe scMEP changes after SCI are correlated with the injury forces and the pathological changes in the cord, which indicates that scMEP can be used as an objective index for the cord functional monitoring.

Animals ; Electric Stimulation ; Evoked Potentials, Motor ; physiology ; Male ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; pathology ; physiopathology

OBJECTIVETo discuss the resection of tumors, reconstruction of defects and the postoperative complications.

METHODSThirty-one patients with tumors around acetabular were treated surgically in People's Hospital between July 1997 and July 2003. The series comprised 19 males and 12 females. Twelve patients were diagnosed with chondrosarcoma, 1 with Ewing sarcoma, 3 with osteosarcoma, 1 with lymphoma, 1 with carcinosarcoma, 1 with malignant fibrohistiocytoma (MFH), 2 with myeloma, 9 with giant cell tumor (GCT), 1 with aneurysmal bone cyst. Among 31 patients with peri-acetabular tumors, 8 were reconstructed with hemi-pelvic prosthesis, 7 with saddle prosthesis, 6 with cauterized tumor bone and total hip arthroplasty, 10 with total hip replacement after curettage of lesion and cemented.

RESULTSAmong 21 patients who underwent tumor resection and reconstruction in region II, 6 had local relapse. Two of 3 patients with osteosarcoma were dead. Five of 12 patients with chondrosarcoma were free of disease. Twenty-one patients with acetabular reconstruction after resection of lesions in region II could sit and stand normally and walked with a cane, several of which even had normal gait.

CONCLUSIONAllograft or pelvic prosthesis can be used to reconstruct the acetabulum after resection of tumors. We must pay more attention on the following points in the surgical treatment of periacetabular tumors: (1) Extensively resect tumors as far as possible; (2) Be acquainted with advantages and disadvantages of different reconstructive methods of acetabulum to prevent the complications; (3) The reconstructed acetabulum is unstable, so the patients must stand with a cane to protect the reconstructed hip joint; (4) Prevent wound necrosis and infection; (5) Surgical treatment of pelvic tumors would easily result in poor wound healing especially in the patients receiving chemotherapy or radiotherapy because of extensive soft tissue stripping. The destroyed soft tissue caused by chemotherapy or radiotherapy may increase the great tissue tension after implantation of allograft. And the factors of poor blood supply and hematoma in the wound theoretically increase the chance of infection.

Acetabulum ; surgery ; Adolescent ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Child ; Female ; Hemipelvectomy ; methods ; Humans ; Male ; Middle Aged ; Pelvic Neoplasms ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies

OBJECTIVESTo define the role of high transthoracic approach in the treatment of cervicothoracic and high thoracic tumor, and analyze the problem encountered during tumor resection and reconstruction of this technique and oncological results of patients who received this type of surgery.

METHODSTwenty-one patients with cervicothoracic and high thoracic tumor (T(1 - 4)) were treated with high transthoracic approach. This series included metastatic tumor 11 patients, eosinophilic granuloma of bone 2 patients, osteosarcoma 1 patient, Ewing's sarcoma 2 patients, chondrosarcoma 2 patients, giant cell tumor 2 patients, lymphoma 1 patient. High transthoracic approach was applied to these patients for tumor resection and spinal cord decompression. Reconstruction method included artificial vertebrae implantation or bone graft implantation combined with anterior internal fixation.

RESULTSChest-back pain of all patients relieved significantly after operation. Paraplegia of 3 patients was improved from grade A to grade D according to Frankel grading system, the other 2 patients recovered completely. Pulmonary infection and pulmonary atelectasis occurred in 2 patients; cerebrospinal fluid leakage happened in 1 patient; thoracic aorta rupture happened in 1 patient. The follow-up period was 11 - 58 months, 9 patients died, including 7 patients with metastatic cancer, 1 patient with Ewing's sarcoma, 1 patient with osteosarcoma.

CONCLUSIONSHigh transthoracic approach is a satisfactory method in dealing with the lesion of cervicothoracic and high thoracic vertebrae, especially with the lesion involving the vertebrae and single vertebral arch. The thoracic canal can be decompressed effectively by this approach.

Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Scapula ; surgery ; Spinal Neoplasms ; surgery ; Thoracic Surgical Procedures ; Thoracic Vertebrae ; surgery ; Treatment Outcome

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

OBJECTIVETo explore the effects and complications of the total elbow arthroplasty after the resection of the peri-elbow tumor.

METHODSBetween June 1998 to June 2007, 19 patients underwent total elbow arthroplasty after resection of tumors at the authors department, which involved 13 males and 6 females, including 6 patients with metastatic tumor, 1 with giant cell tumor of bone (GCT), 2 with malignant fibrous histiocytoma (MFH), 4 with osteosarcoma, 3 with Ewing sarcoma, l with lymphoma, 1 with synovial sarcoma, and 1 with desmoid fibroma of the bone. The age of patients ranged from 15 to 71 years (mean 43 years).

LOCATIONdistal humerus in 9 cases, proximal ulna in 5 and the tumor involving both distal humerus and proximal ulna in 5 patients.

RESULTSPatients were evaluated according to the Mayo Elbow Performance Score. Pain scores decreased from a mean of 3.6 to 2.0. Mean arc of elbow motion from extention to flexion improved from 30 to 80 (range, 55 - 105). Fourteen elbows had excellent or good result (14/19, 77.8%), and 4 elbows had a poor result (22.2%). There was no wound infection or other complication after surgery. During the following up time, 2 patients with metastatic lung cancer, 1 with metastatic rectal cancer and 1 with ovarian cancer died in 2 years after surgery. Two Ewing sarcoma, 1 MFH and 1 osteosarcoma patients occurred lung metastasis (4/18, 22.2%), and two patients had local recurrence (11.1%). Three patients occurred complication during the following time (3/18, 16.7%), the stem of humerus prosthesis came out of channel in 1 case 5 years after surgery, the stem of ulna prosthesis came out of channel in 1 case 4 years after surgery, and both cases did revision surgery. The stem loosening was in 1 humerus prosthesis 4 years after surgery.

CONCLUSIONSThe results show that total elbow arthroplasty after resection of tumors can decrease the pain, and improve the function substantially. For metastatic tumors, this technique also can be used if there is no other good option.

Adolescent ; Adult ; Aged ; Arthroplasty, Replacement ; Elbow Joint ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms ; surgery ; Postoperative Care ; Treatment Outcome