Objective To detect the asymptomatic cardiovascular changes in children with adenoid hypertrophy.Methods One hundred and twenty children with adenoid hypertrophy underwent both chest X-ray and echocardiography before adenoidectomy,and echocardiography 6 months after operation.Results No child showed an increase in the cardiothoracic ratio on X-ray.But preoperative echocardiography showed an increase in pulmonary artery pressure [(22.6 ±3.6) mm Hg,1 mm Hg =0.133 kPa],a decrease in E/A (1.01 ± 0.17),and an increase in right ventricular end-diastolic diameters [(1.88 ± 0.18) cm].While after operation,pulmonary artery pressure decreased to(17.1 ± 3.2) mm Hg,E/A increased to 1.25 ± 0.12,and right ventricular end-diastolic diameters decreased to (1.67 ± 0.11) cm.Each index change before and after operation was statistically significant(P ＜ 0.05).Conclusion Adenoid hypertrophy can result in clinically asymptomatic cardiopulmonary changes.Early diagnosis and treatment of this disease can prevent serious cardiopulmonary complications.

In order to make a report on 90 cases of insomnia treated by the Wei-defensive qi-regulating and brain-strengthening needling technique,as a clinical subject of the multiple center,for assessing the preliminary standardized indications and operating methods and making an initial summary for writing the draft of the technique operation.Methods:By ratio of 1:1,the patients in conformity with the criteria were randomly divided into the experimental group and control group.In the experimental group,45 cases were treated with the Wei-defensive qi-regulating and brain-strengthening needling technique on Baihui (GV 20),Dazhui(GV 14),Shenmai(BL 62),Zhaohai(KI 6),plus ear points.In the control group,45 cases were treated with routine acupuncture on Sishencong(Ex-HN 1),Shenmen (HT 7),Sanyinjiao(SP 6),etc.The therapeutic effects in the two groups were observed and assessed in comparison.Results:The results showed cure in 15 cases.remarkable effect in 27 cases,effect in 42 cases,failure in 6 cases,and the total eriective rate in 94.4% in 90 cases of insomnia.In the three centers,the statistic management was performed based upon PSQI integral and showed significant difference(P＜0.01),and no significant difference among various groups(P＞0.01).Conclusion:The therapeutic effect in the treatment of insomnia by Wei-defensive qi-regulating and brain-strengthening needling technique is better than the control group and the therapeutic effect and methods in various centers are stable.without any deviation.

OBJECTIVE: Panel reactive antibody (PRA) can induce acute rejection following kidney transplantation, however, it is poorly understood which PRA is more associated with rejection. Therefore, the aim of this study is to analyze the correlation between PRA and rejection by observing the change of PRA Ⅰ and PRA Ⅱ prior to and after the kidney transplantation. METHODS: Levels of PRA Ⅰ and PRA Ⅱ were observed in 100 patients received kidney transplantation at the Department of Urology, Beijing Chaoyang Hospital Affiliated to the Capital Medical University. During these 100 patients, 18 patients had PRA changes after operation. The relationship between PRA changes after kidney transplantation and acute rejection were analyzed. RESULTS: Totally 18 patients were included in the final analysis. Nine of them occurred acute rejection with obviously increased PRA Ⅱ (P=0.040), however, the PRA Ⅰ had no significant changes (P=0.707). The changes of PRA Ⅰ and PRA Ⅱ had no significance in the remaining 9 patients prior to and after kidney transplantation. The overall level of PRA increased in 7 patients, in 5 patients with increased PRA Ⅱ, 4 patients suffered acute rejection, 1 of which was renal allogreft failure; 2 cases with PRA Ⅰ increasing did not occur acute rejection. The overall level of PRA declined in 11 patients, including 5 patients with PRA Ⅱ decreased, 1 patient occurred acute rejection; 4 patients in 6 patients with PRA Ⅰ declined suffered acute rejection. CONCLUSIONS: The increased PRA Ⅱ after transplantation easily result in acute rejection, which has definite correlation to acute rejection, however, the PRA Ⅰ changes has no impact on acute rejection.

Aim Tongluoxingnao effervescent tablets ( TLXNET) ,based on the ancient formula of QiongGui Tang, can improve cognitive dysfunction in different AD models. This research is aimed to study the effects of TLXNET on the Aβmetabolism and explore the anti-AD mechanism in SH-SY5 Y-APP and SH-SY5 Y-C99 cells. Methods Cells were incubated for 48h in dif-ferent concentrations of medicated serum ( containing 0% ~40% of TLXNET in the serum ) . Firstly, the non-toxic concentration was measured by MTT assay, the activity of cells was detected by LDH methods, and ELISA was used to measure the levels of Aβ1-40 and Aβ1-42 . Then, the gene and protein expressions of APP were detected via RT-PCR and Western blot of which the expressions of shearing fragments such as sAPPα and sAPPβ were investigated by Western blot, the same as the expressions of IDE and NEP. Addi-tionally, the level of mRNA, protein and activity of BACE1 were measured by qRT-PCR, Western blot and fluorescence detection kits respectively. Eventually, MTT assay was performed to detect the cell viability after the SH - SY 5 Y cells were treated with various concentrations of medicated serum and Aβ25-35 for 48h. Results There was no significant toxicity of TLXNET medicated serum in SH-SY5 Y-APP and SH-SY5 Y-C99 cells ( P >0 . 05 ) . TLXNET could signifi-cantly inhibit Aβ secretion in SH-SY5 Y-APP cells ( P<0 . 05 ) , but had no effect on Aβ secretion in SH-SY5Y-C99 cells, the same as the level of APP mRNA and protein in SH-SY5 Y-APP cells and the expressions of IDE and NEP (P>0. 05). Additionally, TLXNET could still notably inhibit the expression of sAPPβ pro-tein in a dose-dependent way, with statistical signifi-cance ( P <0. 05 ) . Meanwhile, the level of mRNA, protein and activity of BACE1 were also significantly decreased by TLXNET (P <0. 01). Moreover, the medicated serum of TLXNET had a protective effect on SH-SY5 Y apoptosis induced by Aβ25-35 ( P <0 . 01 ) . Conclusion TLXNET could obviously inhibit β-secretase enzyme, and has an antagonistic effect a-gainst Aβneurotoxicity, which suggests that the inhibi-tion of β-secretase enzyme and antagonism against Aβneurotoxicity are the main anti-AD mechanism of TLX-NET .

Objective To investigate the effect of paclitaxel drug-coated balloon (DCB) dilatation in treating coronary in-stent restenosis (ISR) occurring after drug-eluting stent (DES) implantation,and to observe the long-term changes of the target vascular lumen area in order to clarify the curative effect of paclitaxel DCB in treating ISR.Methods Four patients with ISR whose clinical condition met the DCB indication were selected.According to the standard process,sufficient pre-expansion of ISR was performed first,then paclitaxel DCB dilatation was carried out to dilate the lesion segment of ISR,and no stent was implanted.Both coronary angiography and intravascular ultrasound (IVUS) were performed immediately after the treatment as well as 9 months to measure the minimum lumen area (MLA) and cross-sectional area (SA) of the stent,and the intimal hyperplasia was also been evaluated.Results In all 4 patients,angiography performed immediately after paclitaxel DCB dilatation showed that neither dissection of the dilated segment of the target artery nor obvious residual stenosis was observed.Angiography performed 9 months after the treatment revealed that all dilated segments of the target arteries were patent,and no pronounced restenosis of stent segment was seen.IVUS examination was indicated that MLA became enlarged,SA showed an increasing trend,and intimal hyperplasia showed a tendency to be inhibited.Conclusion For the treatment of ISR,pure paclitaxel DCB dilatation can obtain long-term lumen area enlargement,thus,repeated stent implantation can be avoided,which,in turn,can reduce the risk of ISR recurrence.Paclitaxel DCB dilatation can locally release paclitaxel,which has curative effect on the coronary artery wall to inhibit the excessive proliferation of intima.

Objective To study the significance of the sample S/Co ratio when using a domestic reagent for anti-hepatitis C virus(HCV)antibody detection and to explore the procedure and standard of anti-HCV antibody diagnosis by using this domestic reagent.Methods Anti-HCV antibody was detected in 295 000 blood donors by a domestic anti-HCV reagent with enzyme-linked immunosorbent assay(ELISA)method and the reactive samples were tested again by ortho anti-HCV antibody reagent.The samples which anti-HCV antibodies were determined as positive by ortho anti-HCV rea- gent were examined by recombinant immunoblot assay(RIBA)reagent and 106 samples of them were also tested for HCV RNA.Results Six hundred and eighty-one samples were reactive in 295 000 samples screened by the domestic ELISA reagent,the reactive ratio was 0.23 %.Among the reactive samples screened by the domestic ELISA reagent,367 samples were determined as positive by ortho anti-HCV reagent while 66.2% of them showed a S/Co ratio≥3.8.The consistency rate between positive results determined by the domestic reagent and RIBA reagent respectively was 53.8%.For the samples showing S/Co ratio≥3.8 by ortho anti-HCV reagent,94.2% had a S/Co ratio≥8.0 when using the domestic ELISA reagent,while the percentage of samples showing S/Co ratio

OBJECTIVETo analyse retrospectively 3-tunnels core decompression with implantation of bone marrow stromal cells(bMSCs) and decalcified bone matrix (DBM) for treatment of femoral head necrosis in early stages, and to study its therapeutic results and indications.

METHODSAccording to the University of Pennsyvania system of classification and staging,to treat the patients with 3-tunnels core decompression with implantation of bone marrow stromal cells (bMSCs) and decalcified bone matrix (DBM) for treatment of early femoral head necrosis. Among the total 87 patients (103 hips), the male was 71 (86 hips) and the female 16 (17 hips) with the average age of 47 years old. The average course of disease was 1.3 year. The effect was evaluated by the clinical symptoms, the Harris' scores and the manifestations of radiology before and after operation.

RESULTSAll the patients were followed up more than 2 years (average 26 months). The average Harris' scores increased from preoperation 47.3 to postoperation 74.0. The average rate of excellent and good results was 75.7%. The rate of excellent and good was 88% (22/25) in type I, 78.7% (37/47) in type II and 61.3% (19/31) in type III. No severe complications were observed.

CONCLUSIONThree-tunnels core decompression with implantation of bMSCs and DBM not only removal the focus of disease, but also use DBM the induction of bone and autologous hone marrow stem cells to differentiate the functions of the femoral head can be resumed loading structure, eliminate pain,improve joint function. It is an effective method for early femoral head necrosis.

Adult ; Aged ; Bone Marrow Transplantation ; Bone Matrix ; transplantation ; Decompression, Surgical ; Female ; Femur Head Necrosis ; surgery ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Middle Aged ; Retrospective Studies ; Transplantation, Autologous

BACKGROUNDMalignant tumor is the most common complication occurred in transplant recipients. It is widely recognized that immunosuppressive treatments increase the risk of cancer in transplant recipients. The efficacy and safety of rapamycin (RPM) in combination with low-dose calcineurin inhibitor (CNI) in treating 15 renal allograft recipients which developed urothelial carcinoma were observed.

METHODSImmunosuppressive regimen in all recipients was altered with rapamycin to replace mycophenolate mofetil (MMF) or azathioprine (Aza). The initial loading dosage was 2 mg/d, and the next dosage was 1 mg/d. The dosage of rapamycin was carefully adjusted according to the blood drug level and concentration of the drug was maintained at 4 - 6 microg/L. In all the 15 patients, the calcineurin inhibitor was reduced down to one third of the original dosage after the rapamycin blood concentration became stable. Surgical treatment and intravesical instillation chemotherapy were carried out in all patients. Recurrence of the tumor was monitored throughout the study. Post-transplant renal function and side effects were also closely monitored.

RESULTSAmong the 15 patients, 9 had no tumor recurrence in 2 years, 2 had tumor recurrences twice, and 4 had once. There was no acute rejection observed during RPM treatment. Post-transplant renal function in 11 patients was improved, with a decreased creatinine level. Hyperlipoidemia and thrombocytopenia were the most frequent adverse events which responded well to corresponding treatments.

CONCLUSIONAmong the renal allograft recipients with urothelial carcinoma, combination of rapamycin and low dose calcineurin inhibitor treatment is effective and safe.

Adult ; Azathioprine ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Sirolimus ; therapeutic use ; Urinary Bladder Neoplasms ; drug therapy ; pathology ; Urothelium ; pathology

OBJECTIVETo compare the clinical effects and radiographic outcomes of mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits.

METHODSFrom August 2009 and August 2012, 95 patients with thoracolumbar mono-segmental vertebral fractures without neurological deficits were treated with short-segment pedicle fixation through mini-open trans-spatium intermuscular or percutaneous approach. There were 65 males and 30 females, aged from 16 to 60 years old with an average of 42 years. The mini-open trans-spatium intermuscular approach was used in 58 cases (group A) and the percutaneous approach was used in 37 cases (group B). Total incision length, operative time, intraoperative bleeding, fluoroscopy, hospitalization cost were compared between two groups. Visual analog scale (VAS) and radiographic outcomes were compared between two groups.

RESULTSAll patients were followed up from 12 to 36 months with an average of 19.6 months. No complications such as incision infection, internal fixation loosening and breakage were found. In group A, fluoroscopy time was short and hospitalization cost was lower than that of group B (P<0.05). But the total incision length in group B was smaller than that of group A (P<0.05). There was no significant differences in operative time, intraoperative bleeding, postoperative VAS and radiographic outcomes between two groups (P>0.05). Postoperative VAS and radiographic outcomes were improved than that of preoperative (P<0.05).

CONCLUSIONThe mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation have similar clinical effects and radiographic outcomes in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits. However, in this study, the mini-open trans-spatium intermuscular approach has a short learning curve and more advantages in hospitalization cost and intraoperative radiation exposure times, and is recommendable.

Adolescent ; Adult ; Female ; Fluoroscopy ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Visual Analog Scale

The standardized training is an indispensible stage for the improvement of residents' comprehensive quality and for the training of high-qualified talents.The article preliminarily explored the standardized training model for residents,which was in accordance with the characteristics of the department of cardiology mainly from four aspects:the set-up of reasonable training program,the training of practical skills,the training of humanistic quality and the training of life-long learning ability.