OBJECTIVETo compare anatomical differences between subinguinal and ilioinguinal approaches for the treatment of acetabular fracture and investigate clinical therapeutic effect of subinguinal approach.

METHODSSeven fresh human bodies were chosen, comparative study were performed on the right and left side on the same specimen. Ilioinguinal approaches were adopted on the left and subinguinal were adopted on the right. Inner part of incision started to sun wild above pubic symphysis at 2 cm, and lateral incision ranged from iliac to anterior superior spine about 5 cm. Length and transverse diameter of the first window exposed and lliopsoas freeness were tested and compared. Fifteen acetabular fracture patients treated through subinguinal approach were compared from May 2010 to August 2012. Among all patients, including 12 males and 3 females aged from 20 to 65 years old with an average of 40.6 years old. Matta criteria were used to evaluate clinical outcomes.

RESULTSLength and transverse diameter of the first window exposed and lliopsoas freeness through subinguinal approach were better than through ilioinguinal approach (P<0.01). In 15 patients with acetabular fracture, 10 patients obtained anatomical reduction and 10 patients got satisfied reduction in accordance with Matta criteria. X-ray results of all patients were excellent.

CONCLUSIONCompared with ilioinguinal approach, subinguinal approach could enlarge visualization of the first window and simplify surgical procedure. It is an ideal approach to expose anterior and anterior-medialis wall of acetabulum and anterior hip capsule.

Acetabulum ; injuries ; surgery ; Adult ; Aged ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Groin ; Humans ; Male ; Middle Aged

Objective To determine the risk factors for emergence agitation (EA) during the recovery period after general anesthesia.Methods One thousand and thirty-four patients of both sexes aged 18-89 yr undergoing general anesthesia were divided into EA group and non-EA group.EA occurring during recovery from general anesthesia was assessed by using Riker sedation-agitation scale.Age,sex,complication,education,medical history,ASA physical status,type and duration of anesthesia and operation,volume of blood loss,fluid replacement,urine volume,duration of stay in PACU,number of drainage tubes and so forth were recorded.Multivariate logistic regression was used to analyze the risk factors for the occurrence of EA.Results Thirty-six patients developed EA during recovery from anesthesia.The incidence of EA was 3.5 ％.Logistic regression indicated that high risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation were the risk factors for EA (P ＜ 0.05).Conclusion High-risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation are the risk factors for EA during recovery from general anesthesia.

Objective To explore the correlation among serum total bilirubin (TBil) , invasive hemodynamic parameters, plasma N-terminal proBNP (NT-preBNP) and C reactive protain (CRP)in patients with heart failure. Methods Invasive hemodynamic parameters derived from Swan-Ganz catheter, TBil, plasma NT-proBNP and CRP within 12 hours after hospital admission were analyzed in 130 patients with chronic heart failure [Now York Heart Association (NYHA) class Ⅱ -Ⅳ]. Results Compared with those in non-hyperbilirubinemia group, pulmonary capillary wedge pressure (PCWP), NT-proBNP and left ventriculure ejection fraction were different significantly in total hyperbilirubinemia group [(26. 09 vs 16.00) mm Hg(1 mm Hg =0. 133 kPa), (3.36 vs2.91) pmol/L, (34. 12 vs 28.92)%, P<0. 05]. The serum TBil increased significantly in higher PCWP, right atrial pressure and NT-proBNP groups than those in lower level groups [(32. 22 vs 24. 17), (37.52 vs 24. 19), (32. 14 vs 16. 74) pmol/L, P < 0.05]. Partial correlation analysis showed serum TBil was associated with PCWP, right atrial pressure, pulmonary vascular resistance index and NT-proBNP respectively (r = 0. 21, P = 0. 02; r = 0. 33, P < 0. 01 ; r = 0. 20, P =0. 04;r = 0. 37, P <0. 01, respectively). Multiple linear regression analysis showed both right atrial pressure and NT-proBNP correlated independently with serum TBil(β= 0. 39, P < 0. 01 ;β = 0. 29,P = 0. 01, respectively). Conclusion For patients with heart failure, serum TBil correlated well with right atrial pressure, PCWP and NT-proBNP; it is a reliable indicator for exact clinical evaluation of heart failure.

OBJECTIVETo compare therapeutic effects between suspine rotation and flexion manipulation for treating lumbar disc herniation.

METHODSFrom December 2008 to January 2011, 134 patients with lumbar disc herniation were treated, including 74 males and 60 females,ranging in age from 17 to 67 years,33 patients with age over 50 years old. According to diagnosis the ladder of the 9 cases bulging type, 74 hernia type, 51 cases free type. The patients were randomly divided into treatment group ( 69 cases) and control group (65 cases). All the patients were treated with the three-dimensional computer-controlled traction therapeutic apparatus,with continued traction for 20 minutes. After traction, flexion manipulation and rotat-ing manipulation were respectively adopted in treatment group and control group (on alternate days one time, 3 times as a course of treatment). The symptoms and signs (including back pain and discomfort, lower limb pain and numbness, powerless urination and defecation,numbness in perineum, straight-leg raising degree,ability of lower extremity walking,work and live) of patients were observed after treatment.

RESULTSAll patients were followed up for 0.5 to 6 months with an average of 1.1 months. After treatment, the symptoms and signs of patients have significantly improved (P < 0.01), but the symptomes of powerless urination and defecation,numbness in perineum was not improved obviously (P>0.05). Forty-two of 69 patients in treatment group got excellent result, moderate in 20, poor in 7; Twenty of 65 patients in control group got excellent result, moderate in 25,poor in 20.

CONCLUSIONThe whole effect of lumbar backwards rotation manipulation is more satisfactory than flexsion manipulation for treating lumbar intervertebral disc herniation. But spinning force and times should be noticed.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Lumbar Vertebrae ; physiopathology ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Recovery of Function ; Rotation ; Young Adult

This study was aimed to investigate the expression level of NF-kappaB mRNA in acute myeloid leukemia (AML) using real time fluorescence quantitative polymerase chain reduction (qPCR) detection and to explore the effect of NF-kappaB mRNA in pathogenesis of AML. The fresh bone marrow was collected from 60 newly diagnosed patients with AML, the total RNA was extracted by means of RTIzoL, the cDNA was synthesized, the expression of NF-kappaB mRNA was detected by qPCR using GAPDH as internal reference. 12 normal healthy persons were selected as controls. The results showed that the expression of NF-kappaB mRNA in patients with AML was higher than that in normal healthy persons with significant difference (p<0.05), the expression of NF-kappaB mRNA in patients with AML-M4 and -M5 were higher than that in patients with AML-M1, -M2 and -M3. It is concluded that the expression of NF-kappaB mRNA is higher in patients with AML. The up-regulation of NF-kappaB expression in patients with AML may play an important role in pathogenesis of AML.
Adolescent ; Adult ; Aged ; Bone Marrow ; metabolism ; Case-Control Studies ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; NF-kappa B ; genetics ; metabolism ; RNA, Messenger ; genetics ; Young Adult

OBJECTIVETo compare the predictive values of eight staging systems for primary liver cancer in the prognosis of combined hepatocellular-cholangiocellular carcinoma (cHCC-CC) patients after surgery.

METHODSThe clinical data of 54 cHCC-CC patients who underwent hepatectomy or liver transplantation from May 2005 to Augest 2013 in Chinese PLA General Hospital were collected. We evaluated the prognostic value of the Okuda staging system, Cancer of the Liver Italian Program (CLIP) score, French staging system, Barcelona Clinic Liver Cancer (BCLC) staging system, 7th edition of tumour-node-metastasis (TNM) staging system for hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC), Japan Integrated Staging (JIS) score, and Chinese University Prognostic Index. The distribution, Kaplan-Meier method, Log-rank test, and area under a receiver operating characteristic curve were used to compare the prognosis-predicting ability of these different staging systems in 54 cHCC-CC patients after surgery.

RESULTSThe TNM staging system for ICC and JIS score had a better distribution of cases. The 12-and 24-month survivals of the entire cohort were 65.5% and 56.3%, respectively. A Log-rank test showed that there was a significant difference existing in the cumulative survival rates of different stage patients when using TNM staging system for ICC (stage 1 vs. stage 2, P=0.012; stage 2 vs. stage 3-4, P=0.002), Okuda staging system (stage 1 vs. stage 2, P=0.025), and French staging system (stage A and stage B, P=0.045). The 12-and 24-month area under curve of TNM staging system for ICC, BCLC staging system, JIS score, and CLIP score were 0.836 and 0.847, 0.744 and 0.780, 0.723 and 0.764, and 0.710 and 0.786, respectively.

CONCLUSIONThe 7th edition of TNM staging system for ICC has superior prognostic value to other seven staging systems in cHCC-CC patients undergoing surgical treatment.

Bile Duct Neoplasms ; diagnosis ; surgery ; Carcinoma, Hepatocellular ; diagnosis ; surgery ; Cholangiocarcinoma ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; Neoplasm Staging ; methods ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Survival Rate

The aim of this study was aimed to investigate the molecular genetic basis for a novel HLA allele, HLA-B*4061, in Chinese population. DNA was extracted from whole blood by salting-out method. The HLA-B exons 1 - 8 of the proband was amplified and the amplified product was cloned using TOPO TA cloning sequencing kit to split the two alleles apart. Both strands of exons 2, 3 and 4 of chosen colonies were sequencing. The PCR-SSP was performed to confirm the mutations detected by sequencing. The sequencing results showed HLA-B alleles of the proband as B*4601 and the novel allele. The sequences of the novel allele have been submitted to GenBank (DQ089628, DQ089629, DQ089630). After HLA blast analysis, the novel allele showed a single nucleotide mismatch with B*400101 in exon 2 at position 272 C-->A, as the results, changing amino acid from Ser to Tyr at codon 67. It is concluded that this allele is a novel one and has been officially named B*4061 by the WHO Nomenclature Committee.
Alleles ; Amino Acid Substitution ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; HLA-B Antigens ; genetics ; immunology ; Histocompatibility Testing ; Humans ; Molecular Sequence Data ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid

OBJECTIVETo explore the mechanism of pricking blood therapy (PBT) for allergic rhinitis (AR).

METHODSThe model rat of experimental allergic rhinitis (EAR) was established by administration of ovoglohulin and they were divided into five groups randomly: a model group, a PBT group, a TCM point application group, a beclomethasone dipropionate (BDP) treatment group, and a health control group. Adrenocorticotrophic hormone (ACTH) contents in hypothalamus, pituitary gland, adrenal gland and plasma were determined by radioimmunoassay before and after treatment.

RESULTSThe ACTH levels in the hypothalamus, pituitary gland, adrenal gland and plasma in the rat of EAR were lower than those in the health control group (P < 0.01). After treatment of pricking blood ther, ACTH levels in the above tissues increased significantly (P < 0.01), with very significant differences (P < 0.01) as compared with the model group, similar to those in the BDP group (P > 0.05).

CONCLUSIONPricking blood therapy has a regulatory action on ACTH in HPA axis of rats with experimental allergic rhinitis.

Adrenocorticotropic Hormone ; Animals ; Hypothalamo-Hypophyseal System ; Hypothalamus ; Pituitary-Adrenal System ; Rats ; Rhinitis, Allergic

Objective To construct a 5-lipoxygenase (5-LO) transgenic mouse model of atherosclerosis.Methods Purified 5-LO fragment was injected into male pronucli and the firtilized eggs were transplanted into pseudopregnant mice.PCR and Southern blot were used to detect the genotype of DNA separated from the newborn mouse tail tissues.RT-PCR and Western blot analysis were used to detect the gene transcription and expression.Results PCR and Southern blot results showed that 7 of 25 mice were transgenic mice.Expression of 5-LO and FLAP was found in the bone marrow,spleen,kidney,and peritoneal cells.Results of RT-PCR and Western blot showed that No.9,20,24transgenic mice expressed a higher level of 5-LO and FLAP than those in the wild type C57BL/6 mice.The expression levels in bone marrow and peritoneal cells were significantly different(P<0.05).Conclusion A 5-LO transgenie mouse line has been established in this study and may be used for future study on the function of 5-LO gene.

Adult ; Aged ; Female ; Humans ; Joint Instability ; complications ; diagnosis ; physiopathology ; surgery ; Lumbar Vertebrae ; pathology ; physiopathology ; Male ; Middle Aged ; Spinal Canal ; pathology ; physiopathology ; Spinal Stenosis ; complications ; diagnosis ; physiopathology ; surgery