Eustachian Tube ; abnormalities ; surgery ; Humans ; Laser Therapy ; Male ; Middle Aged ; Prosthesis Implantation ; Stents ; Tympanoplasty

AIM: Recent studies showed that stem cells could replace injured cardiomyocyte and increase the number of functional cardiomyocytes. Researching the pertinent literature in China Journal Full-text Database (CJFD) published between 2005 and 2008 indicated that the researches on stem cell transplantation in the treatment of primary dilated cardiomyopathy were few. This study investigated the therapeutic efficacy and security of peripheral blood stem cell transplantation in coronary artery in treatment of dilated cardiomyopathy and its effects on left ventricular function. METHODS: Forty-two patients with dilated cardiomyopathy between December 2006 and September 2007 were enrolled at the Department of Cardiology of First People's Hospital of Yunnan, including twenty-eight males and fourteen females, averagely aged (56?3) years. Inclusive criteria: patients with less than 65 years, left ventricular enlargement, and left ventricular ejection fraction (LVEF) ≤ 45%, and without coronary artery disease after coronary arteriongraphy. Informed consents were obtained from patients. Patients were divided into stem cell transplantation group (n=15) and control group (n=27) on the basis of whether being treated by stem cell transplantation. Patients in the stem cell transplantation group were consecutively administered granulocyte colony-stimulating factor (G-CSF) by hypodermic injection to stimulate bone marrow stem cells themselves based on conventional treatment for five days. Peripheral blood stem cell suspension was disassociated on the 6th day, and the collected suspension was injected into left anterior descending branch over the wire saccule tube for autologous peripheral blood stem cell transplantation. Patients in the control group were administered by conventional treatment of dilated cardiomyopathy. Security and adverse reaction were observed during the mobilization, collection and returning injection of peripheral blood stem cell by coronary artery. Morphous, cardiac function and motion index of left ventricle wall were evaluated using ultrasoundcardiogram before and 3 months after transplantation. Survival rate and incidence rate of heart incidents were compared. RESULTS: Three months after stem cell transplantation in coronary artery, there were a significant decrease in cardiac end-systolic volume (ESV), cardiac end-diastolic volume (EDV) and motion index of left ventricle wall, but a significant increase in LVEF(P

Objective To investigate the imaging characteristics of lymphoscintigraphy in postoperative breast cancer patients and evaluate its diagnostic value in breast cancer-related lymphedema (BCRL).Methods Seventy-nine breast cancer patients who underwent mastectomy and axillary lymph node dissection were studied. Patients ( n = 158 ) were divided into the study ( affected arms, n = 79 ) and control groups ( contralateral arms, n = 79). After subcutaneous injection of 99Tcm-dextran via the first interphalangeal space, lymphoscintigraphy was performed at 10 min, 1,3, 6 h respectively. Sensitivity and specificity of lymphoscintigraphy for detection of BCRL were calculated. Results There were significant differences in the amount of visualized lymph nodes, lymphatic integrity and backflow pattern between the two groups.Lymphatic drainage was preserved in 96.2% (76/79) of the contralateral arms and only 5.1% (4/79) of affected arms. 87.3% (69/79) and 74.7% (59/79) of control arms had ≥2 lymph nodes in axilla and supraclavicular regions, respectively; while none ( 0/79 ) and 5.1% (4/79) of the affected arms had ≥ 2lymph nodes in both regions, respectively. Four backflow patterns of radiotracer in subcutis were observed in the affected arms: normal (2.5% , 2/79), dilatated (55.7%, 44/79), diffused (36.7%, 29/79) and without backflow (5.1%, 4/79 ). The sensitivity and specificity of "lymphatic integrity" and "backflow pattern" on lymphoscintigraphy for detecting BCRL were 97.5% (77/79) and 96.2% (76/79), 94.8%(73/77) and 100.0% (81/81), respectively. Conclusion Lymphoscintigraphy is a noninvasive, accurate and effective imaging modality for the evaluation of BCRL.

Objective To evaluate the lymphoscintigraphic imaging characteristics for the patients with lower limb lymphedema and to establish a novel grading system for the injury to lower limb lymphatic system. Methods One hundred and sixty six consecutive patients (332 lower limbs) with lower limb lymphedema after surgical and(or) radiotherapy treatment for gynecological cancer were recruited into this retrospective study. The lymphoscintigraphy studies were performed after subcutaneous injection of 111～185 MBq (0. 1～0. 15 ml) of 99Tcm-DX into the webbed space between the first and second toes of both feet. Based on the integrity of lymphatic vessel and the extension of dermal diffusion on lymphoscintigram,the lymphatic injury to the lower limb was graded as 0, 1,2 and 3 respectively. The lymphedema of the limb was staged as 0, Ⅰ , Ⅱ a, Ⅱ b, Ⅲ by the standard of Consensus Document of the International Society of Lymphology (ISL). Chi square test was carried out to validate the established grading system for the assessment of the injury to the lower limb lymphatic system. Results The lymphoscintigraphic imaging characteristics included lymphatic blockage, dermal backflow, no visualization of lymphatic or lymph node, lymphocele and lymph fistula in the lower limb, pelvis and abdomen. There were 65 (19.6%), 71 (21.4%),131 (39.5%), 62 (18.7%) and 3 (0.9%) limbs staged as 0, Ⅰ , Ⅱa, Ⅱb, and Ⅲ for lymphedema while 36(10.8%), 79(23.8%), 116(34.9%) and 101 (30.4%) limbs graded as 0, 1, 2, and 3 for lymphatic injury. There was a statistically significant correlation between the grading methods (χ2 =313.483, P <0.001). The patients who underwent radiotherapy had a higher incidence rate of grade 2 and 3 (70.5%, 158/224) than those who underwent surgery (53.6%, 59/108) (χ2 = 9.662, P = 0.022).The patients with erysipelas had a higher incidence rate of grade 3(73.1%, 38/52) than those without erysipelas (43.9%, 50/114) (χ2= 12.238, P<0.001). The incidence rate of grade 3 increased with the duration of lymphedema after treatment: 36.6% (34/93) for less than 1.5 years, 72.3% (34/47) for between 1.5 to 5 years, and 76.9% (20/26) for more than 5 years (χ2 = 23.123, P<0.001). The grade of lymphatic injury showed no significant difference among 3 types of gynecological cancers (χ2 = 4.000, P =0.676), or between the patients with and without chemotherapy (χ2 =0.411, P=0.938). Conclusions Lymphoscintigraphy is a reliable modality to diagnose lower limb lymphedema after treatment for gynecological cancer. The injury grading system could provide objective assessment of the lymphatic damage.

Objective To evaluate the clinical effectiveness of interventional therapy in treating thoracic aortic dissection (TAD) . Methods A follow-up visit with 24 TAD patients had been operated in our hospital from November 2008 to March 2010. The clinical data, the therapeutic measures and the follow-up results were retrospectively analyzed. Including the remission of symptom, average day in hospital,complication,the long term survival rates and so on. Results All 24 patients have survived, the symptoms have improved instantly, the hospitalization days was 7.3 days,and no complication occurred. The 3 years survival rate was 95.8%. Conclusion Interventional therapy have advantages of treating thoracic aortic dissection with less complication,more secure and higher long term survival rates.

Objective To investigate the prevalence of integrons in A.baumannii isolates,analyze the correlation between inte- grons and resistance of A.baumannii,and study the resistance genes in integrons.Methods A total of 106 strains of A.bau- mannii were collected to test the antibiotic susceptibility by disk diffusion method.The classification of integrons was per- formed by analyzing the positive PCR products using restriction fragment length polymorphism (RFLP).The variable region of integrons was amplified by integron PCR.RFLP and DNA sequencing were used to analyze the resistance genes in integrons. Results About 52.8% (56/106) of the isolates showed integron positive.PCR-RFLP analysis revealed that they were all class I integrons.About 94.6%(53/56) of the positive strains with integrons owned the variable region,which was confirmed by integron PCR.The sizes of the amplicons ranged from 0.15 kb to 2.8 kb.All together 7 different cassette arrays were detec- ted,including genes coding resistance to aminoglycosides (aadA1,aadA2,aadA5,aadB,aacA4),sulphonamides (dfrⅫ, dfr17),?-lactam compounds (bla_(ara-10)),chloramphenicol (catB-like,catB8),and two open reading frames (orfF,orfI) with unknown function.A novel cassette array orfI-aadA1 was reported,and its GenBank accession number was DQ092497.Conclu- sions Class I integrons are widespread in A.baumannii isolates in Nanjing.The integrons are closely associated with the resist- ance and multidrug resistance in A.baumannii isolates.

Objective To compare the influences of off-pump and on-pump coronary artery bypass grafting operation on plasma thyroid hormones.Methods Forty patients undergoing coronary surgery were randomly divided into off-pump group(n=20)and on- pump group(n=20).Plasma thyroid hormones(T_3,T_4,FT_3,FT_4,rT_3)and thyroid-stimulating hormone(TSH)were studied perio- peratively.Results Before operation,the values of aU the variables were within normal range in the two groups.In off-pump group, T_3 and FT_3 concentration dropped significantly after operation,reaching the lowest value at first day postoperatively[T_3:(39.7?6.2) ng/dl vs.(78.6?2.1)ng/dl,P0.05),which were within normal range all along,rT_3 concentration rose significantly after operation,reaching the highest value at third day postoperatively[(82.1?26.8)ng/dl vs.(42.3?15.6)ng/dl, P0.05),whereas baseline,operative and postoperative variables were similar.Con- clusion Off-pump operation has some influences on plasma thyroid hormones,showing"low T_3 syndrome"postoperatively,that is similar to what on-pump operation does.

Osteoarthritis (OA) is a complex chronic progressive disease attacked by biological and mechanical factors and a result from the anabolic and catabolic imbalance in chondrocyte, subchondral bone and extracellular matrix(ECM). Etiology and pathological of OA are not yet entirely clear. The degradation and destruction of collagen II caused by matrix metalloproteinase -13 (MMP-13) is considered the core factor in the occurrence and development of OA. The research of MMP-13 inhibitor provide ideas and methods for the treatment of OA. In this article,the role and determination of MMP-13 in OA and the development prospect of MMP-13 inhibitor in the treatment of OA research progress were reviewed.
Animals ; Collagen ; metabolism ; Humans ; Matrix Metalloproteinase 13 ; analysis ; physiology ; Matrix Metalloproteinase Inhibitors ; therapeutic use ; Osteoarthritis ; drug therapy ; etiology

OBJECTIVETo observe the therapeutic angiogenesis effect of naotai recipe (NR) on local ischemia/reperfusion (I/R) injury of rats by observing signaling pathway of hypoxia-inducible factor-lα (HIF-1α) and vascular endothelial growth factor (VEGF).

METHODSTotally 120 Sprague-Dawley (SD) rats were randomly divided into 4 groups, namely, the normal control group (n =12), the sham-operation group (n =12), the I/R model group (n =48), and the NR group (n =48). Cerebral I/R injury models were established using thread suture method. Rats in the I/R model group and the NR group were sub-divided into 4 sub-groups according to the 1st, 3rd, 5th, and 7th I/R day (n =12). The phenomenon of neovasculization was observed by immunofluorescence staining. The protein and mRNA expression levels of HIF-la, VEGF-A, and VEGFR II receptor were detected by RT-PCR.

RESULTSThere were a large amount of labels for neovasculization in the ischemic area of the NR group. Double-immunofluorescence labeling [vWF (red) and BrdU (green)] was observed in the NR group. Compared with the model group, the HIF-1α protein expression was obviously enhanced on the 1 st day of I/R (P <0.01), and the VEGF protein expression started to enhance on the 3rd day in the NR group (P <0.01). The VEGFR protein expression level was the highest in the NR group on the 5th day of I/R (P <0.01). The protein expression of VEGF and HIF-1α started to decrease on the 7th day of I/R.

CONCLUSIONNR could strengthen angiogenesis after I/R by elevating the expression of HIF-lα and activating HIF-lα/VEGF signaling pathway.

Animals ; Brain Ischemia ; metabolism ; Cerebral Infarction ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; Ischemia ; Neovascularization, Pathologic ; Rats, Sprague-Dawley ; Reperfusion Injury ; Signal Transduction ; Vascular Endothelial Growth Factor A ; biosynthesis

OBJECTIVETo discuss the clinical effects of open reduction and internal fixation (ORIF) for treatment of patients with Lisfranc injury combined the second metatarsal base comminuted fracture.

METHODSFrom March 2007 to June 2012, 7 patients with Lisfranc injury combined the second metatarsal base comminuted fracture were treated including 5 males and 2 female aged from 22 to 51 years old (means 42 years), 4 of sprain and 3 of traffic injury. According Myerson classification, there was 1 case of type A, 3 of type B and 3 of type C. Kirschner wire was used to fix Lisfranc ligament placing from the medial cuneiform bone to the second metatarsal base during the operation. After the operation American Orthopaedic Foot and Ankle Society (AOFAS) criteria system were applied to evaluate the foot and ankle function. Preoperative and postoperative AP, lateral and oblique X-ray and CT scan were collected for radiographic evaluation.

RESULTSAll patients were followed up from 12 to 20 months (16.8 months in average). According to AOFAS criteria system, 3 cases were excellent result,3 good, 1 fair. All the wounds were primary healing without skin necrosis, infection, Kirschner loose,broken, or other complications.

CONCLUSIONKirschner wire had good clinical efficacy for fixing Lisfranc ligament injury with the second metatarsal base comminuted fracture, and could avoid arthrodesis.

Adult ; Bone Wires ; Female ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged ; Tarsal Joints ; injuries ; surgery ; Wound Healing