BACKGROUND: Fibular fixation and tantalum rod implantation are two commonly used methods for the treatment of early osteonecrosis of the femoral head (ONFH), both of which can effectively delay or even reverse the progress of ONFH. However, further comparative evaluation on their mechanical properties and therapeutic efficacy is required.OBJECTIVE: To compare the clinical efficacy of fibular fixation and tantalum rod implantation on ONFH at early stage.METHODS: Fifty-eight patients (81 hips) suffered from ONFH with ARCO stage 1 and stage 2, and underwent fibular fixation (30 cases, 41 hips) or tantalum rod implantation (28 cases, 40 hips). Postoperatively, both groups were followed up for over 2 years. The Harris scores of the hip were compared between two groups before and after treatment. With femoral head collapse and the collapse distance > 4 mm as observation points, the survival rate of the femoral head was compared between two groups.RESULTS AND CONCLUSION: The postoperative Harris scores of the two groups were significantly improved than before (P < 0.05). With the appearance of femoral head collapse as the observation point, the Kaplan-Meier survival curve showed that the overall survival rate of the hip was 83% in the fibular fixation group and 65% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0431). With > 4 mm collapse as the observation point, the Kaplan-Meier survival curve showed that overall survival rate of the hip was 95% in the fibular fixation group and 83% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0418). To conclude, both fibular fixation and tantalum rods implantation applied to ONFH at early stage can effectively improve the hip function, and the survival rate of the hip at ARCO Stage IIC is better in patients undergoing fibular fixation than tantalum rod implantation.

OBJECTIVETo investigate the significance of detecting specific serum IgG antibodies in clinical diagnosis of SARS as well as affecting factors.

METHODSEnzyme-linked immunoassay kit for SARS coronavirus antibodies developed by HuaDa Biological Company was applied to detect specific serum IgG from SARS patients and the production of SARS specific antibodies among patients of different age groups, sex and with or without steroid treatment were statistically compared.

RESULTSOut of 121 patients studied, 71.1% were SARS specific IgG positive. Patients younger than 15 years, between 15 to 59 years, older than 59 years had positive rates of 60.0%, 70.2%, and 85.7%, respectively with no statistically significance (P=0.766); patients with or without steroid treatment showed positive rates of 70.6% and 72.4%, respectively (P=0.84); patients exhibiting either severe or light syndromes showed positive rates of 78.1% and 67.4%, respectively (P=0.493); both male and female patients showed the same positive rate of 71.1%.

CONCLUSIONThe sensitivity of the SARS specific IgG kit utilized needs to be further improved. The production of SARS IgG is not notably correlated with sex, age, seriousness of symptoms, and steroid treatment.

Adolescent ; Adult ; Aged ; Antibodies, Viral ; blood ; Child ; Female ; Humans ; Immunoglobulin G ; immunology ; Male ; Middle Aged ; SARS Virus ; immunology ; Sensitivity and Specificity ; Severe Acute Respiratory Syndrome ; diagnosis ; immunology

OBJECTIVETo explore the pharmacologic mechanism of cinnabar (CA) and realgar (RG) in Angong Niuhuang powder (ANP) by way of studying the characteristics of their effects on organism under physiologic and pathologic states.

METHODSSD rats were randomly divided into six groups, 8-10 rats in each group. Group A: untreated normal rats; Group B: normal rats administered by ANP (drug I) 278 mg/kg; Group C: normal rats administered by ANP subtracted CA and RG (drug II) 222.7 mg/kg; Group D: brain edema model rats established by unilateral common carotid artery injection of Bacillus pertussis 250 million/kg; Group E: model rats administered by ANP 278 mg/kg 1 hr before modeling; Group F: model rats administered by drug II 222.7 mg 1 hr before modeling. Blood sample and brain tissue in Group D were obtained 4 hrs after modeling and those in other groups obtained 5 hrs after drug administration. The total activity of lactate dehydrogenase (LDH) in serum and brain tissue was determined by colorimetry and that of serum LDH isoenzymes (LDH(1-5)) were determined by gel electrophoresis.

RESULTSAs compared with Group A, LDH, LDH1 and LDH2 activities increased in Group D (P < 0.01), and increased also in Group B and C (P < 0.05), while LDH4 and LDH5 decreased obviously in Group B and C. But except that of LDH5, no significant difference of LDH(1-4) in brain tissue and serum was shown in comparison of Group B and C. As compared with Group D, LDH was lower (P < 0.01) and LDH5 was higher (P < 0.01) in Group E and F without significant difference, LDH2, LDH3 were lower in Group E (P < 0.01) but unchanged in Group F, LDH1 and LDH4 were not changed in Group E but significantly lowered in Group F (P < 0.05 and P < 0.01).

CONCLUSIONAdministration of ANP in normal physiologic condition would cause damage on myocardium and kidney to certain extent, administration of ANP and drug II in pathologic (infectious brain edema) would suppress the hyper-activated LDH, with no significant difference between the effects of drug II and ANP. However, CA and RA in ANP are proven to have influence on the serum LDH isoenzymes, indicating that the two ingredients may have some potential pharmacological effects.

Animals ; Arsenicals ; pharmacology ; Brain Edema ; enzymology ; etiology ; Drugs, Chinese Herbal ; chemistry ; Encephalitis ; complications ; Isoenzymes ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Male ; Mercury Compounds ; pharmacology ; Powders ; Rats ; Rats, Sprague-Dawley ; Sulfides ; pharmacology

OBJECTIVETo observe the protective effect of metformin on the endothelial function and the mechanisms in rats with low-density lipoprotein (LDL) injection.

METHODSA single dose (4 mg/kg) of natural LDL was injected through the sublingual vein of rats to induce vascular endothelial dysfunction. Blood samples were then collected from the rats to detect the concentrations of malondialdehyde (MDA) and nitric oxide (NO), activity of superoxide dismutase (SOD) and serum lipid levels. The thoracic aorta of rats was obtained to assay acetylcholine (ACh)-induced endothelium-dependent relaxation (EDR) and sodium nitroprusside (SNP)-induced endothelium-independent relaxation. The effects of metformin pretreatment on the endothelial functions in the rats were investigated.

RESULTSA single-dose LDL significantly inhibited ACh-induced EDR without affecting SNP-induced endothelial-independent relaxation. The injection decreased serum NO and elevated serum MDA level, but had no effect on serum lipid level. Metformin markedly attenuated LDL-induced inhibition of EDR, serum MDA elevation, and serum NO reduction without affecting the serum lipid levels.

CONCLUSIONMetformin provides protection against vascular endothelial dysfunction induced by LDL in rats, the mechanism of which is probably associated with protection of endothelium-dependent relaxation factor and inhibition of the oxidative stress.

Animals ; Endothelium, Vascular ; drug effects ; physiopathology ; Endothelium-Dependent Relaxing Factors ; metabolism ; Lipoproteins, LDL ; administration & dosage ; Male ; Malondialdehyde ; blood ; Metformin ; pharmacology ; Nitric Oxide ; blood ; Oxidative Stress ; drug effects ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; Vasodilation ; drug effects ; physiology

Objective To investigate the clinical efficacy of finger reconstruction in child with second toe transplantation,and evaluate the postoperative appearance and function regarding the reconstructed donor feet.Methods From June 2002 to May 2011,sixteen cases were reconstructed in sub-emergency with second toe transplantation.Two thumbs,eight index fingers,and 6 middle fingers were reconstructed.All patients were followed-up from 12 to 24 months.The functions of reconstructed fingers were analysed.Results All the reconstructed fingers survived.Vascular crisis occurred in 1 patient,and survived after re-anastomosis.Necrosis of skin grafts at the domon site with exposed tedons was seen in 1 ease,and healed after changing dressings.All the reconstructed fingers showed good in growth and development,and performed good functions as grabbing,grasping and nipping.Two-point discrimination was between 6 mm and 10 mm.The donor site of the foot had normal gait,without obvious influence on walking.Also,no pain was complained.Conclusion The method of transplanting the second toe can reconstruct the appearance and function of the finger defects in child,and has little effect on the appearance and motion of feet.It is an effective treatment method.

OBJECTIVETo compare the effects of Bushen Jiedu Recipe (BJR) and Jianpi Jiedu Recipe (JJR) containing plasma on dendritic cells (DCs) of chronic hepatitis B virus (HBV) infection patients under different immune states.

METHODSRecruited were 36 chronic HBV infection outpatients from First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from April 2010 to January 2011. They were assigned to the immune tolerance group (18 cases) and the immune clearance group (18 cases).Another 10 healthy subjects were recruited as the healthy control group. Their anticoagulated peripheral venous blood was respectively collected. The peripheral blood mononuclear cells (PBMCs) were isolated and further extracted for incubating DCs. The DCs were intervened by BJR and JJR containing plasma. The morphology of DCs was identified. The expressions of CD1alpha, CD80, CD86, and HLA-DR were detected. The level of interferon-alpha (IFN-alpha) in the supernatant was observed by ELISA.

RESULTSThe CD80 expression level was lower in the immune clear group than in the healthy control group before intervention (P < 0.05). The expression levels of CD80, CD86, and HLA-DR were lower in the immune tolerance group than in the healthy control group before intervention (P < 0.05).The IFN-alpha expression level was lower in the immune tolerance group and the immune clearance group than in the healthy control group before intervention (P < 0.05). The expression levels of CD80, HLA-DR, and IFN-alpha were lower in the immune tolerance group than in the immune clearance group before intervention (P < 0.05). Compared with the same group before intervention, the CD80 expression significantly increased in each treatment group (P < 0.05). After intervention the expression levels of CD80 and HLA-DR were higher in the immune tolerance group than in the immune clearance group in the same time phase, and the CD86 expression level was higher in the BJR group than in the immune clearance group in the same time phase, showing statistical difference (P < 0.05).

CONCLUSIONSThe middle dose BJR and the small dose JJR both could promote the recovery of DCs in chronic HBV infection patients. Besides, BJR showed more prominent effects on the function of DCs in chronic HBV infection patients in the immune tolerance stage.

Adult ; B7-1 Antigen ; metabolism ; B7-2 Antigen ; metabolism ; Case-Control Studies ; Dendritic Cells ; drug effects ; immunology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; HLA-DR Antigens ; metabolism ; Hepatitis B, Chronic ; blood ; drug therapy ; immunology ; Humans ; Immune Tolerance ; drug effects ; Interferon-alpha ; metabolism ; Male ; Phytotherapy ; Plasma ; Young Adult

As one of the earliest markers for predicting pregnancy outcomes,human chorionic gonadotropin (hCG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer (ET).In this retrospective study,patients with positive hCG (day 12 after transfer) were included to examine the hCG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles.For patients who got clinical pregnancy,the mean initial hCG value was significantly higher after frozen cycles than fresh cycles,and the similar result was demonstrated for patients with live births (LB).The difference in hCG value existed even after adjusting for the potential covariates.The area under curves (AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 mIU/mL for clinical pregnancy after fresh ET,0.894 and 399.50 mIU/mL for clinical pregnancy after frozen ET,0.812 and 222.86 mIU/mL for LB after fresh ET,and 0.808 and 410.80 mIU/mL for LB after frozen ET with acceptable sensitivity and specificity,respectively.In conclusion,single frozen blastocyst transfer leads to higher initial hCG values than single fresh blastocyst transfer,and the initial hCG level is a reliable predictive factor for predicting IVF outcomes.

Objective To observe the clinical effect of dexmedetomidine for preventing agitation during extubation period in the patients undergoing percutaneous nephrostolithotomy.Methods Sixty ASA Ⅰ-Ⅱ patients with elective percutaneous nephrostolithotomy under general anesthesia were selected and randomly assigned to the dexmedetomidine (DEM) and normal saline group (NS),30 cases in each group.The DEM group was given dexmedetomidine 0.5 μg/kg by intravenous pumping at 30 min before the end of the operation,while the NS group was given the equal volume of normal saline by intravenous pumping for 10 min.MAP and HR were recorded before anesthesia induction(T0),at the end of skin suturing(T1),at the moment of extubation(T2),at 5 min (T3) and 10 min(T4)after extubation.The eye opening time and extubation time,and incidence of agitation were observed in the two groups.Results MAP and HR at T2,T3 and T4 in the DEM group were lower than those in the NS group(P＜0.05).MAP and HR at T2,T3,T4 in the NS group were higher than those before anesthesia induction(P＜0.05).The total incidence rate of agitation during extubation period in the DEM group was also significantly lower that that in the NS group(P＜0.01).No statistically significant differences were found between the two groups in the recovery time and extubation time(P＞0.05).Conclusion Intravenous pumping of dexmedetomidine 0.5 μg/kg at 30 min before the end of percutaneous nephrostolithotomy can effectively reduce the occurrence of agitation during extubation period.

0.05).Conclusion The distribution of G990R CASR genotype in PHPT patients is different from healthy women,and R allele is higher in PHPT group.Among PHPT patients,A986S and G990R polymorphisms are associated with serum calcium and ICa levels.Patients with S or G allele have lower levels of serum calcium and ICa.A986S genotype is also associated with serum PTH level and patients with S allele have relatively lower level of PTH.

OBJECTIVETo investigate the association between vitamin D deficiency and risk of gestational diabetes mellitus (GDM) in pregnant Chinese women.

METHODSA nested case-control study was conducted. Clinical and biochemical data were analyzed for 200 subjects with GDM and 200 subjects with normal glucose tolerance (NGT).

RESULTSThe median (interquartile range) serum 25-hydroxyvitamin D (25OHD) levels were 22.39 (17.67, 29.38) and 25.86 (19.09, 34.88) nmol/L in the GDM and NGT groups, respectively. Rates of 25OHD deficiency or insufficiency were significantly higher in the GDM group than in the NGT group. Subjects with 25OHD levels <25 nmol/L had a 1.8-fold higher risk of GDM compared with subjects with higher vitamin D levels. In the GDM group, serum 25OHD was independently associated with HbA1c and insulin resistance after adjusting for confounding factors. In the NGT group, serum 25OHD was independently associated with fasting plasma glucose and systolic blood pressure after adjusting for maternal age and other confounding factors.

CONCLUSION25OHD insufficiency is very common in Chinese women. Low 25OHD status may be associated with insulin resistance and act as a risk factor for GDM.

Adult ; Asian Continental Ancestry Group ; Diabetes, Gestational ; blood ; epidemiology ; Female ; Humans ; Pregnancy ; Vitamin D ; analogs & derivatives ; blood ; Vitamin D Deficiency ; blood ; epidemiology