Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury.Methods Twenty-five patients with cervical spinal cord injury were randomized into an experimental group (n =13) and a control group (n =12).The control group was given comprehensive rehabilitation treatment,including upper limb movements,standing training and training of respiratory function,while the experimental group was given repetitive transcranial magnetic stimulation and abdominal muscle electrical stimulation in addition to the comprehensive rehabilitation treatment.The patients' maximum lung capacity (VC),forced expiratory volume for 1 second (FEV1),peak expiratory flow rate (PEF) and tidal volume (VT) were measured at the outset and after 3 months of treatment.Results The lung function indexes increased in both groups after treatment,but each index improved significantly more in the experimental group,on average,than in the control group.Conclusion As a supplement to routine respiratory function training,repetitive transcranial magnetic stimulation combined with abdominal intermediate frequency electrical stimulation can improve the pulmonary ventilation function of patients with middle and lower cervical spinal cord injury.

Three butylphthalide derivatives were isolated from the Rhizome of Ligusticum chuanxiong using a series of isolation and purification approaches including macroporous resin, ODS-A column, Sephadex LH-20 and preparative HPLC. These structures were elucidated based on extensive spectroscopic data (UV, IR, HR-ESI-MS and NMR) and identified as (3Z,3aE)-(6R,7R,2'S)-6-hydroxy-7-(2-carboxyl-2-hydroxyethylthio)-3-(2-hydroxybutylidene)-4,5,6,7-tetrahydro-phthalide (1), (3Z,3aZ)-3-butylidene-6,7-dihydroxy-4,5,6,7-tetrahydro-phthalide 7-O-α-D-glucopyranosyl-(1→2)-β-D-fructo-furanoside (2) and 3-(3-β-D-glucopyranosyloxy-butylidene)-7-hydroxy-phthalide (3).

We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treatment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation.
Bone Plates ; Femur ; Fibula ; Fracture Fixation, Internal ; Fractures, Bone ; Humans

AIMTo determine whether the cardioprotection of ischemic postconditioning and heptanol in ischemic heart against ischemia/reperfusion (I/R) is mediated by gap junction.

METHODSThe effect of ischemic postconditioning, heptanol at different doses (0.03, 0.06, 0.30, and 0.60 mg/kg) and AAP10 (10 mg/kg) on the intact rat heart during 30 min ischemia and 2 h of reperfusion was observed. Ischemic postconditioning was achieved by 3 cycles of 10 s reperfusion/10 s regional ischemia starting at the beginning of the reperfusion. The infarct size and the arrhythmia scores were measured. The effect of ischemic postconditioning, heptanol at different doses (0.05, 0.10, 0.50 and 1.00 mmol/L) and AAP10 (1 x 10(-7)mol/L) on the isolated heart during 30 min ischemia and 2 h of reperfusion was observed. Ischemic postconditioning was achieved by 6 cycles of 10 s reperfusion/10 s global ischemia starting at the beginning of the reperfusion. The arrhythmia scores and conduction velocity of ventricle muscle were measured.

RESULTSIn the intact rat heart model, ischemic postconditioning and heptanol reduced infarct size and arrhythmia scores. In the Langendorff perfused rat heart model, ischemic postconditioning and heptanol reduced arrhythmia scores and conduction velocity of ventricle muscle. Administration of AAP10, an opener of gap junction attenuated the cardioprotection of ischemic postconditioning and heptanol.

CONCLUSIONThe cardioprotection of ischemic postconditioning and heptanol may be related to the attenuation of gap junction communication on myocardiac ischemia/reperfusion injury.

Animals ; Gap Junctions ; physiology ; Heptanol ; pharmacology ; Ischemic Postconditioning ; methods ; Male ; Myocardial Ischemia ; physiopathology ; Myocardial Reperfusion Injury ; physiopathology ; prevention & control ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the effects of recombinant human epidermal growth factor (rhEGF) on deep partial thickness burn wound healing.

METHODSThe rats were inflicted with deep partial thickness burn. The wounds were either treated with rhEGF, rhEGF with heparin or isotonic saline, respectively. Wound healing time was observed. Wound healing rate, water content and hydroxyproline (OHP) content and type I/III collagen ratio in the wound tissue were determined. Cellular DNA cycle analysis and histological examination were processed.

RESULTSAfter the application of rhEGF, burn wound healing time was shortened by two days and wound content of OHP was increased (P < 0.05), with decreased collagen type I/III ratio (P < 0.05). As a result, granulation was enhanced and cellular DNA replication was accelerated (P < 0.05). Heparin addition could augment the effects of rhEGF, especially on wound healing time (2 days shorter) and granulation.

CONCLUSIONThe wound healing time of the deep partial thickness burn could be accelerated markedly by topical application of rhEGF, but early application did not show obvious effects. The addition of heparin might further accelerate wound healing.

Animals ; Burns ; drug therapy ; pathology ; Epidermal Growth Factor ; pharmacology ; Epithelial Cells ; pathology ; Female ; Heparin ; pharmacology ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; pharmacology ; Wound Healing ; drug effects

OBJECTIVETo evaluate whether garlicin can prevent reperfusion no-reflow in a catheter-based porcine model of acute myocardial infarction (AMI).

METHODSTwenty-two male Chinese mini swines were randomized into 3 groups: sham-operation group (n=6), control group (n=8), and garlicin group (n=8). The distal part of left anterior descending coronary artery (LAD) in swines of the latter two groups was completely occluded by dilated balloon for 2 h and a successful AMI model was confirmed by coronary angiography (CAG) and electrocardiograph (ECG), which was then reperfused for 3 h. In the sham-operation group, balloon was placed in LAD without dilatation. Garlicin at a dosage of 1.88 mg/kg was injected 10 min before LAD occlusion until reperfusion for 1 h in the garlicin group. To assess serial cardiac function, hemodynamic data were examined by catheter method before AMI, 2 h after occlusion and 1, 2, and 3 h after reperfusion. Myocardial contrast echocardiography (MCE) and double staining with Evans blue and thioflavin-S were performed to evaluate myocardial no-reflow area (NRA) and risk area (RA).

RESULTSLeft ventricular systolic pressure and left ventricular end-diastolic pressure significantly improved in the garlicin group after reperfusion compared with the control group P<0.05) and 2 h after AMI (P<0.05). MCE showed garlicin decreased reperfusion NRA after AMI compared with the control group (P <0.05). In double staining, NRA/RA in the garlicin group was 18.78%, significantly lower than that of the control group (49.84%, P<0.01).

CONCLUSIONSGarlicin has a preventive effect on the porcine model of myocardial infarction reperfusion no-reflow by improving hemodynamics and decreasing NRA.

Allyl Compounds ; pharmacology ; therapeutic use ; Animals ; Cardiotonic Agents ; pharmacology ; therapeutic use ; Contrast Media ; Disease Models, Animal ; Disulfides ; pharmacology ; therapeutic use ; Hemodynamics ; drug effects ; Male ; Myocardial Infarction ; complications ; diagnostic imaging ; drug therapy ; pathology ; Myocardial Reperfusion ; No-Reflow Phenomenon ; complications ; diagnostic imaging ; drug therapy ; pathology ; Swine ; Swine, Miniature ; Thiazoles ; metabolism ; Ultrasonography

Objective To investigate the clinical value of endoscopic stent implantation combined with X-ray monitoring in the treatment of malignant gastroduodenal obstruction. Methods 70 cases of malignant obstruction of stomach and duodenum from January 2013 to December 2015 were enrolled. According to the patients' hospitalization sequence, the odd number of patients were enrolled in the study group, the even number of patients were enrolled in the control group, 35 cases in each. The difference is that the study group were performed in metallic stent placement under fluoroscopic monitoring and endoscopic direct vision, while the control group only under endoscopic direct vision. Record the operation time, the success rate and accuracy of disposable implantation, diseases, thedisplacement and falling of the stent, and complications. we statistically analyzed the data. Results The operation time of the intervention group on average was (9.71 ± 3.60) min, while the control group was (21.01 ± 5.20) min. The success rate and accuracy of disposable implantation of the intervention group was 97.14%, while the control group was 77.14%; After 4 weeks after stent patency rate were 97.14%, 74.28% in the control group; Two groups are with the same diseases. All of the patients had small amount of bleeding, which were stoped after treatment. There was no gastrointestinal ulcers, 1 case with stent displacement, 1 case with gastrointestinal complications, 1 case with metabolic complications in the intervention group. There was 4 cases with stent displacement, 6 cases with gastrointestinal complications, 7 case with metabolic complications the control group. Conclusion Gastroscope-X-ray combined with metallic stent implantation in the treatment of malignant gastroduodenal obstruction, short operation time, high success rate, stent implantation of accurate positioning, less complications, long survival, is a kind of method is simple and feasible, safe and effective.

Objective To observe the expression of vimentin (Vim) after silence of interleukin-1β (IL-1β) in rats with spinal cord contusion (SCC). Methods The model of SCC was established in 30 Sprague-Dawley rats with Allen's method. The rats were randomized into vector group (n=15) and silence group (n=15), which were injected blank lentivirus vector and vector of IL-1β siRNA, respectively; and divided in three, seven and 28 days subgroups. The relationship between IL-1βand Vim was predicted with GeneMANIA bioinformatics. The expression of Vim protein and mRNA in spinal cord was detected with immunohistochemistry and real-time quantitative polymerase chain reaction. Results GeneMANIA bioinformatic analysis indicated that there was some direct and indirect relationship between IL-1β and Vim. The Vim protein and mRNA expressed in the spinal cord, and was less in the silence group than in the vector group (t>2.875, P<0.05). Conclusion Silence of IL-1β can inhibit the expression of Vim in SCC rats, which may promote the recovery of spinal cord function.

BACKGROUNDTransesophageal echocardiography (TEE) is a well-established method for detecting and diagnosing heart tumors. In contrast, its role in assessing the presence, growth and evidence of malignant tumors originating from mediastinal sites remains unclear. The aim of this study was to compare the diagnostic impact of TEE and transthoracic echocardiography (TTE) for determining the localization, growth and malignancy of adult mediastinal tumors (MTs).

METHODSIn a prospective and investigator-blinded study, we evaluated 144 consecutive patients with MT lesions to assess the diagnostic impact of TEE and TTE for detecting the presence of tumors spreading both inside and outside of the heart and for determining infiltration and invasion using pathological examination results as a reference.

RESULTSAll tumor lesions were diagnosed and carefully evaluated by biopsy. Biopsy revealed malignant tumors in 79 patients and benign tumors in 65 patients. When compared to histological findings, TEE predicted malignancy from the presence of tumors spreading both inside and outside of the heart and from infiltration and invasion in 49/79 patients (62.0%). TTE predicted malignancy in only 8/79 patients (10.1%, P < 0.005). TEE visualized tumor lesions in 130 patients (90.3%) while the TTE visualized tumor lesions in 110 patients (76.4%) and was less effective at detecting MT lesions (P < 0.001). TTE and TEE could detect anterior MTs and adequately verified MTs (P > 0.05); TEE detected medium MTs better than TTE (P < 0.001).

CONCLUSIONSTEE is effective and superior to TTE for predicting the localization and growth of MTs as well as for accessing evidence of tumor malignancy. TTE and TEE were able to detect anterior MTs; TEE was able to detect medium MT better than TTE.

Adult ; Aged ; Echocardiography, Transesophageal ; methods ; Female ; Heart Neoplasms ; diagnostic imaging ; Humans ; Male ; Mediastinal Neoplasms ; diagnostic imaging ; Middle Aged ; Prospective Studies ; Young Adult

OBJECTIVETo review the preliminary clinical experience with high-field-strength intra-operative magnetic resonance imaging (iMRI) in the endoscopic chordoma operation with transsphenoidal or transoral approach.

METHODSFrom January 2009 to December 2010, 23 patients [range, 29 - 64 years, mean age (42 ± 3) years] of chordoma were operated with endoscopic transsphenoidal or transoral approach and examined intraoperatively with a movable 1.5 T iMRI magnet. Tumor size range was 2.0 - 5.7 cm, mean (3.5 ± 0.8) cm. A navigation system based on iMRI was used in 20 cases.

RESULTSiMRI scan were performed in each operation from 1 time to 5 times. Neuronavigation system were used in 20 operations and the data renewed in 12 cases by the information from iMRI. In 15 of 23 patients, iMRI had revealed residual lesions and resulted in 12 cases further treatment, eventually, 9 tumors were totally removed and 3 tumors were further removed. The ratio of total removal tumor was enhanced to 73.9% (17/23) from 34.8% (8/23). Among 15 cases of partial chordoma removal detected by scanning in operation, 9 were huge chordoma. The residual of huge chordoma detected by scanning in operation was 9/11, and other chordoma contributed to 6/12. There were no iMRI related safety issue or accident recorded in this study.

CONCLUSIONSHigh-field-strength iMRI provide high-quality images of tumor resection that allows intraoperative modification of the surgical strategy. Combined with the navigation system, iMRI is helpful to maximize the resection of the chordoma and benefit for the safety of endoscopic operation.

Adult ; Chordoma ; surgery ; Endoscopy ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neuronavigation ; methods ; Pituitary Neoplasms ; surgery ; Sphenoid Sinus ; surgery