Adult ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Powders

Disasters ; Emergency Medical Services ; Humans ; Wounds and Injuries ; therapy

BackgroundRetinitis pigmentosa (RP) has the genetic and phenotype heterogeneity.To determine the disease-causing gene is a foundation of gene therapy.Objective This study was to localize the pathogenic gene and screen the gene mutation associated with Han Nationality autosomal dominant retinitis pigmentosa (ADRP) in a Chinese family.MethodsTwenty-one families enrolled this study,including 12 patients with ADRP and 9 individuals with normal phenotype.Perimetry,fundus examination,electrooculogram ( EOG ) and electroretinogram (ERG) were performed in 12 patients.Genetic linkage analysis was performed on the subjects in all known genetic loci related to ADRP with a panel of microsatellite markers.Subsequently,the mutation screening of rhodopsin gene was screened by direct DNA sequencing.This study was approved by Ethic Committee of Zhongnan Hospital of Wuhan University.Informed consent was obtained from each subject.ResultsThe fundus appearance of the proband was in accordance with the ADRP,and the EOG and ERG showed undetectable.Contractive visual field also was exhibited in the proband.Linkage analysis showed that the maximum logarithm of the odds(LOD) score reached 3.6671 at marker D3S1292 at recombination fraction θ =0.0.The results of direct DNA sequencing revealed a C→ G transversion mutation at codon 53 in exon 1 of rhodopsin gene,which resulted in a proline to arginine change (Pro53Arg) in 12 patients.However,no similar mutation was found in the unaffected members of this family.ConclusionsThe missence mutation Pro53Arg in rhodopsin gene cosegregate with the RP disease.It is determined to be a pathogenic factor of this ADRP family.

Objective To compare the clinical effects of intramedullary nails and locking compression plate in the treatment of femur shaft fracture.Methods The clinical data and follow-up records of 43 patients with femur shaft fracture treated by intramedullary nails and locking compression plate were retrospectively reviewed.Including 31 males and 12 females with an average age of 40.07 years(25 to73).According to AO classification:5 cases were type A,24 cases were type B,14 cases were type C.26 patients in group A treated by intramedullary nails and 17 patients in group B treated by locking compression plate.Operation time,fracture union time,blood loss and complications were compared between the two groups.The Karlstrom and Olerud result were compared and analyzed.Results All patients were followed up at an average of 15 months(range 5-24) after surgery.According to Karlstrom and Olerud score system,the excellent and good rate of group A was 88.4％,higher than the group B 82.3％.But there was no significant difference between the two groups.In group A:the operation time (113.77 ±20.14)min,the blood loss in the operation (386.74 ± 65.16) ml,clinical bone healing (15.52 ± 1.77) weeks.All these outcomes were better than group B (P ＜ 0.01).One case in group A appeared screw loose,but X-ray showed the nail stable,the bone wasn't displacement.One case in group B appeared broken plate 1 month after operation,and received twice operation,the clinical outcome was good as well.Another 1 case with fracture delayed union in group B,after internal fixation removed,we check the X-ray showed bone union.Conclusion Two methods of treatment femur shaft fracture can all reach the above requirement.Fixation of intramedullary interlocking nail is the preferred surgery than locking compression plate.

OBJECTIVE To evaluate the clinical outcome of submucosal inferior turbinectomy and outfracture surgery of inferior turbinates. METHODS All patients receiving two different operations were measured by acoustic rhinometry and questionnaire of QOL at preoperative 1 week and postoperative 12 months, seperately. RESULTS Forty-seven patients with inferior turbinate hypertrophy were enrolled in this study. Evaluation of SNOT-20 discovered both surgeries could improve patients' QOL with similar outcome. Preoperative '5 important items' in patients with inferior turbinate hypertrophy were 'lack of a good night's sleep', 'need to blow nose', 'thick nasal discharge', 'fatigue' and 'dizziness'. Postperative '5 important items' were 'postnasal discharge', 'runny nose', 'sneezing', 'reduced concentration' and 'reduced productivity'. Both surgeries could make acoustic rhinometry parameters change obviously, such as minimal cross-sectional area, 0-5 cm nasal volume(NV) and 2-5 cm NV. Furthermore, submucosal inferior turbinectomy produced more volume in nasal cavity than outfacture surgery, (7.28±2.01)cm3 vs (6.01±1.22)cm3, (5.99±1.87)cm3 vs (4.23±1.08)cm3(P<0.05), seperately. There was no correlation between the data of SNOT-20 and acoustic rhinometry. CONCLUSION We recommend outfracture surgery of inferior turbinate as the preferred surgical choice for patients with mild inferior turbinate hypertrophy.

Background Oxidative damage plays an important role in pathogenesis of age-related macular degeneration( AMD ),and its mechanism is the destroy of blood-retinal barrier.Müller cells is a primary component to stabilize the inner barrier of the blood-retina.Researches showed that epidermal growth factor(EGF) can promote the proliferation and migration of animal Müller cells,but less study was found in the effect of EGF on human Müller cells. Objective The present study was to investigate the effects of EGF on the proliferation and migration of human Müller cells and its molecular mechanism. Methods Human Müller cell line MIO-M1 cells were cultured and incubated,and cultured cells were identified using glial fibrillory acidic protein (GFAP),factor Ⅷ,α-smooth muscle actin( α-SMA ),keratin and S-100.Different concentrations of EGF( 0,1,10,30,100 mg/L)was added in freeserum DMEM,and the positive rate of the cells was calculated using 5-bromo-2-deoxyuridine(BrdU) method.The cells were divided into EGF group,H2 O2 group,EGF + H2 O2 group,glucose oxidase ( GO ) group,GO + EGF group,EGF + LY294002+H2O2 group according to the different intervention,and the effects of LY294002 on the proliferation of Müller cells (A590 )were detected by colorimetric assay for cellular growth and survival( MTT assay).The scratch test of Müller cells was used to assess the influence of EGF(0,1,10,30,100 mg/L)on H2 O2-induced damage of human Müller cell.Western blot was used to detect the cell proliferation under the protection of EGF on co-cultured cells using LY294002 and H2O2 and the activation of Akt signal pathways. Results The proliferative rates of the cells were 28.0％,32.9％,39.0％ in 10,30,100 mg/L EGF groups respectively and obviously higher than those in 0,1 mg/L EGF groups (24.5 ％,26.2 ％ ).Under the H2O2 culture,GO culture,respectively,the A570 value of the Müller cell in high concentrations of EGF groups was significantly increased in comparison with lower concentrations EGF groups with the statistical significance among the groups( F=23.582,P=0.000).Compared with EGF+H2O2 group,the A570value of the Müller cells was lowed in EGF+LY294002+H2O2 group.The maximum migration rate of Müller cells was found in 10 mg/L EGF group.Western blot revealed that the presence of H2O2 reinforced the expression of Akt in Müller cells,however,pretreatment with 100 mg/L EGF antagonized the harmful effect of H2O2 on Müller cells.Meanwhile,pretreatment with EGF and LY294002 reduced the expression of Akt in Müller cells. Conclusions EGF can induce the proliferation and migration of human Müller cells with the strongest effect in 10 mg/L.100 mg/L exogenous EGF has a stronger protection to the Müiller cells against H2O2-induced cell damage by activating the PI3KAkt cell survival pathway.

Objective To investigate the pathogenesis of gallbladder chaotic dynamics after partial gastrec-tomy. Methods 140 cases operated by partial gastrectomy after 6 months were randomly examined, they in-cluded one group of 40 cases by Billroth type and the other 100 cases by Eiselsberg type. The ultrasonograph was applied to evaluate the function of gallbladder dynamics and radio-immunity method to determine the content of CCK at the time of having no food and 30 minutes after med. Results BV and RV of Eiselsberg group were bigger than Billroth Ⅰ obviously P<0.05. Gallbladder contraction rate displayed not well obvi-ously as too. The plasm level of CCK had no manifested distinctions in empty stomach cases of the 2 groups, but the increasing gradient plasm level of CCK in Billroth Ⅰ exceeded Eiselsberg type. Conclusions The pathogenesis of gallbladder chaotic dynamics after partial gastrectomy was correlated with the alterative type of partial gastrectomy, the reduction of CCK plasm level, the damage of anterior vagal trunk hepatic branches during the operations and so on led to the disorder of gallbladder emptying and induced cholecystolithiasis.

Objective To investigate the significance of salivary cortisol , dehydroepiandrosterone sulfate (DHEA-S) and cortisol/DHEA-S ratio changes for evaluation of military performance stress .Methods Forty submarine soldiers were selected, whose saliva samples were collected separately at the end of long-term dive training and after nine months of relaxation break.In addition, the saliva samples of thirty-four graduate students were collected the moment they finished a three-hour final examination and one week later .The method of ELISA was used to detect the levels of salivary cortisol and DHEA-S and to count their ratio .Results After long-term dive training , the submarine soldiers showed significantly decreased DHEA-S and an increased cortisol/DHEA-S ratio, but the cortisol level did not change very much .In contrast, the final examination stress did not change the level of cortisol , DHEA-S or the cortisol/DHEA-S ratio among these students.Conclusion This is the first study to show that long-term, chronic military performance stress is associated with the salivary DHEA-S and cortisol/DHEA-S ratio changes .The increase in the cortisol/DHEA-S ratio may be used as an important and useful biomarker to evaluate chronic stress .In addition , it is relatively simple and sensitive to detect stress biomarkers by using saliva samples .

Objective To evaluate the effectiveness and safety of recombinant human endostatin combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy for advanced non small cell lung cancer ( NSCLC) . Methods Electronic databases including the Cochrane library, PubMed, the Chinese biomedical literature database, China national knowledge internet(,EMbase,VIP and Wanfang database system were searched,until August,2013. The inclusion criteria was efficacy and safety studies of randomized controlled clinical studies in which recombinant human endostatin combined with concurrent chemoradiotherapy was compared with concurrent chemoradiotherapy alone for patients with advanced NSCLC. Cochrane handbook 5. 1. 0 was applied in evaluating the quality of included trials and RevMan 5. 1. 0 software was used for data analysis.Results Five studies including 217 cases of advanced NSCLC were included. The results of the meta-analysis exhibited that compared with concurrent chemoradiotherapy alone, recombinant human endostatin combined with concurrent chemoradiotherapy could increase effective rate [OR=2. 62,95%CI(1. 41,4. 86),P=0. 002]. But there were no significant differences in clinical benefit rate [OR=2. 08,95%CI(0. 92,4. 73),P=0. 08],one year survival rate [OR=1. 18,95%CI(0. 53,2. 66),P=0. 68], improvement in quality of life [OR=1. 57,95%CI(0. 40,6. 07),P=0. 52],rate of leucopenia [OR=1. 25,95%CI(0. 72,2. 17), P=0.43],radioactive esophagitis [OR=1. 16,95%CI(0. 42,3. 21),P=0. 77] and radiation pneumonitis [OR=2. 47,95%CI (0. 34,17. 68),P=0. 37]. Conclusion Compared with concurrent chemoradiotherapy alone,recombinant human endostatin combined with concurrent chemoradiotherapy may be more effective for advanced NSCLC,whereas improvement of life quality and toxicities are similar. For the quality restriction and possible publication bias of the included studies,more high quality randomized controlled trials are required to further verify this conclusion.

Objective To evaluate the effect of military performance stress on the changes of concentrations in salivary chromogranin A ( CgA) ,β-endorphin (β-EP) and salivary IgA ( sIgA) of submariners.Methods Twenty-nine submarine soldiers were selected, and their saliva samples were collected separately at the end of a long dive trip and nine months after relaxation ashore.In addition,the saliva samples of twenty-eight graduate students were collected as the normal control.The method of ELISA was used to detect the level of salivary CgA,β-EP and sIgA.Results After long-term dive training, the submariners showed significantly decreased CgA,β-EP and sIgA.Conclusion After a long term dive trip, chronic military performance stress is associated with the decline of salivary CgA,β-EP and sIgA, indicating that the function of sympathet-ic adrenal medulla is suppressed.The biological significance of these changes needs to be assessed in the future.