ObjectiveTo explore the application of finasteride during ipratropium bromide treatment in the elderly with chronic obstructive pulmonary disease. Methods The 263 patients who were hospitalized for chronic obstructive pulmonary disease (COPD) and treated with ipratropium bromide (aged 63-89 years) in Cadre Wards of Ji Shui Tan Hospital from Jan.2006 to Jan.2011 were reviewed.They were divided by gender and combination of benign prostatic hyperplasia (BPH) and treatment of finasteride.The duration of ipratropium bromide treatment,time to dysuria and the severe degree of dysuria were evaluated.Results None of the female patients suffered from difficult urination or discontinued impratropium bromide for abnormal urination,while there were 23.3％ cases with difficult urination,5.8％ catheterization and 3.4％ discontinued bromide in male patients.More patients suffered from catheterization and bromide discontinuance in prostatic hyperplasia group (8.0 ％ and 4.7 ％ ) as compared with non-prostatic hyperplasia group (P＜ 0.05).The occurrence of urethral catheterization for dysuria or ipratropium bromide discontinuance obviously decreased 40％ and 30％,respectively,after finasteride treatment (P＜0.01). Conclusions The COPD patients complicated with BPH should be treated with finasteride to prevent the occurrence of abnormal urination and urinary retention during the treatment of ipratropium bromide.

Objective To discuss application of initiative infrared ray computer assisted 3D navigation system in spinal complex operation to improve surgical safety. Methods From December 2002 to July 2004, we performed 90 cases of spinal operation assisted by computer 3D navigation system. There were 38 cases of spinal fractures, and 236 cases of pedicle fixation. In lumbar spine surgery, fluoroscopy was commonly used, because the pedicle of lumbar spine was thick enough. 3D computer navigation was used in the other cases. Results 4 screws (1.7%) were not in good position, and the position error rate was 0.23 to 0.56 mm (automatically calculated by the computer). But we had once performed 272 cases of fixation with cervical pedicle screws just assisted by G arm or C arm fluoroscopy, 29 (10.7%) of which were not in good position. Conclusion In comparison, computer navigation assisted operation can make pedicle screw positioning more correct.

Technological advances in spinal surgery have brought about changes to the theories and methods of treatment of spinal fractures. New techniques, such as pedicle screw fixation, upper cervical fixation, minimal invasive method, computed navigation method, have made it possible that much more spinal fractures can be treated operatively rather than conservatively. These changes have also made the recovery of patients more satisfactory. But if the new techniques are not used properly, they can do harms to the patients. Therefore, how to apply the new techniques properly and avoid unnecessary harms to the patients at the same time is a serious problem that we must face and solve.

Objective To report a case of neuromyelitis optia with hiccups as the first symptom. Methods 1 case received laboratory examination according to the clinical symptoms, signs, especially aquaporin-4. Results Aquaporin-4 antibody was positive. Conclusion Aquaporin-4 may play an important role in the pathogenesis of neuromyelitis optia.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Herpes Zoster ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Deep vein thrombosis (DVT) is a serious complication of fractures. The incidence of ankle fracture which occurs most frequently intra-articular is 200/100 000, about 3.9%of all fractures. Domestic and foreign reports of ankle fractures and DVT were allocated and analyzed to review their correlation. Furthermore, different methods of rou-tined thromboprophylaxis was discussed. DVT incident after ankle fractures and the necessity of routined thromboprophy-laxis were reviewed. DVT incidence after ankle fractures was low and routine thromboprophylaxis was not necessary to all ankle fracture patients except the ones who had risk factors of thrombosis which could induce DVT.

Objective To investigate the expressions of RTN4 and TG2 in papillary thyroid cancer tissues and their clinical pathological significance.Methods A total of 40 samples of papillary thyroid cancer tissues and 20 samples of para‐carcinoma tissues were collected from the Department of Pathology ,Renmin Hospital of Wuhan University ,China.The expression levels of RTN4 and TG2 were detected by means of immunohistochemical staining and their relationship with clinicopathological charac‐teristics of papillary thyroid carcinoma was analyzed.SPSS 13.0 soft package was used for one‐way analysis of variance and SNK test of the average absorbance and the average positive area rate (α=0.05).Bivariate correlation analysis of the positive area rate of the expressions of RTN4 and TG2 was conducted (α=0.05).Results ①The expression levels of RTN4 and TG2 were much higher in the papillary thyroid carcinoma tissues than those in the para‐carcinoma tissues (P<0.05). ② The expres‐sion levels of RTN4 and TG2 were significantly higher in lymph node metastasis group than those in the group without lymph node metastasis (P<0.05).The positive expression rates of RTN4 and TG2 were much higher in clinical stage Ⅰand Ⅱ groups than those in clinical stage Ⅲ and Ⅳ groups (P<0.05).They were significantly increased in low differentiation group than in high or moderate differentiation group (P< 0.05).The expressions of RTN4 and TG2 were not statistically associated with tumor size ,age and sex (P>0.05). ③The positive correlation was found between the expressions of RTN4 and TG2 in papilla‐ry thyroid carcinoma tissues (r=0.587 ,P<0.05).Conclusion ① The expressions of RTN4 and TG2 were up‐regulated in pa‐pillary thyroid carcinoma tissues ,which is related with over‐proliferation and increase of apoptosis resistance of cancer cells. ②RTN4 and TG2 play an important role in the proliferation and metastasis of papillary thyroid carcinoma. ③ RTN4 and TG2 may play a synergistic role in the development of papillary thyroid carcinoma.

Axial symptom,also called axial pain or axial neck pain,is a common complication after posterior cervical spine surgery.The symptom can be neck pain,as well as rigid,tension and dullness.The incidence of axial syndrome is estimated between 5.2％ and 61.5％.Often,the symptom does not disappear spontaneously.The quality of patients' life as well as the effectiveness of cervical laminoplasty is affected.It can be divided into early and late axial pain based on the onset time.The mechanism and reason are different,but both are difficult to subside.The incident of axial symptom is relatively high in conventional laminoplasty.However the modified one which preserve posterior ligament-muscular structure can reduce the incidence significantly.C2 spinal process as the attachment of cervical semispinalis,could reduce the incidence of kyphosis after operation.And C7 spinal process is an important structure in posterior ligament-muscular structure.Both should be preserved as much as possible in order to maintain intact attachment of muscles,which facilitates the patient to restore soft tissue tension by rehabilitation.Rigid fixation is another method of modification,it could avoid re-close of the open door,and reduce soft tissue injury.However,attention must be paid not to destroy facet joint to cause new axial symptom.Risk factors of axial symptom include past shoulder and neck pain and stiffness,others remain controversial.There is no correlation between loss of range of motion after surgery as well as change of cervical alignment and axial symptom.It is more likely to be a different result due to muscle atrophy.Although there are no golden standard of laminoplasty,doctors should follow these principles:preserve C2 and C7 spinal process when possible,rigid fixation to avoid reclose,reduce immobilization after operation,and encourage patient to start rehabilitation as early as possible to reduce incident of axial symptom.

Objective To develop a method to analyze functional grouping cDNA microarray gene expression in microvessels and neurons from rat brain using laser capture microdissection(LCM). Methods Microvessels and neurons were captured using the PixCell ⅡLCM instrument. The total RNA was extracted from the LCM samples according to the manufacturer's protocol of RNAqueous-Micro kit. The total RNA were processed for one round of T7-based RNA amplification; cDNA probe were synthesized using gene-specific primer and labeled for cDNA microarray analysis. Results Amplified RNA from microvessels and neurons allowed us to measure 96 gene expression in functional grouping cDNA microarray. Conclusion LCM allowed us to harvest pure microvessels and neurons from their native tissue environment, combined with methods of T7 RNA amplification and gene-specific primer amplification so that we can analyze functional grouping cDNA profiling in LCM samples.

Purpose Placenta implantation (PI) is a rare but severe pregnancy complication, and imaging diagnosis is always difficult. This paper aims to explore the ideal fast-imaging MRI sequences for PI and to provide high quality images for diagnosis. Materials and Methods The MRI images of 21 cases with pathology confirmed PI were retrospectively analyzed. Prenatal MRI of 2D fast-imaging employing steady-state acquisition (2D FIESTA) and single-shot fast spin echo (SSFSE) sequences were performed, and the imaging quality rating and the accuracy in detecting PI were compared. Results Satisfactory images were acquired in 71.4% (15/21) of the patients using 2D FIESTA, and 38.1% (8/21) using SSFSE with statistically significant difference (χ2=4.790, P<0.05). The MRI features of PI included placenta heterogeneity, low-signal-intensity bands, abnormal placental vascularity, uterine junction zone interruption, placental tissue invading the myometrium, placenta tissue into uterine serosa, and the detection rates of 2D FIESTA and SSFSE sequences on the above features were 57.1%, 57.1%, 28.6%, 61.9%, 66.7% and 14.2%, respectively; 90.4%, 71.4%, 38.1%, 42.9%, 28.6% and 6.5%, respectively. The detection rates of placenta heterogeneity and placental tissue invading the myometrium using these two sequences are statistically different (χ2=4.560 and 6.109, P<0.05). Conclusion The images quality of 2D FIESTA sequence is higher than those of the SSFSE sequence. 2D FIESTA sequence shows better delineation of the border of the placenta and uterine, and SSFSE sequence shows better contrasts of the placenta;therefore, combining these two can improve MRI diagnostic value for PI.