Objective To assess the sacrococcygeal microcirculation and the change trend of complete spinal cord injury patients,and in order to provide evidence for turn-over time of spinal cord injury patients.Methods The spinal cord injury patients that met the inclusion criteria were set as the experimental group,patients with orthopedic trauma were named as the similar control group.And certain healthy volunteers were named as the healthy control group.The sacrococcygeal microcirculation of supine position for 1h,and lateral position for 0.5 h was monitored using Doppler blood flow monitor system,then take load period 0min、15m in 、30min、45min、60min,recovery period 0min、15min、30min as research points,the blood perfusion value and the change trend were monitored and analyzed.Results The sacrococcygeal microcirculation in SCI patients were significantly less than two control groups after 30min in supine position,and the blood flow increased at first and then decreased within one hour.While the healthy subjects increased gradually within one hour.Conclusions The time of position change for SCI patients should be reassessed,the interval should be controlled in one hour.

Objective To study the relationship between spinal shifting and C5 palsy after posterior approach cervical decompression surgery (PACDS).Methods Twenty-four patients underwent PACDS were examined with MRI before and one month after operation.The spinal shifting were measured.Clinical and imaging characteristics of patients with post-operative C5 palsy were observed.Analyzed the correlation between C5 palsy and spinal shifting after operation.Results The average spinal shifting was (2.41 ± 0.46) mm.Three cases developed C5 palsy,whose spinal shifting at C5 level was significantly greatert han those without C5 palsy.Conclusion Excessive posterior spinal shifting after PACDS can drag C5 nerve root leading to C5 palsy.

Objective To investigate the effect of fire needling on tumor marker CA-125 levels and endometrial antibody (EMAb) in endometriosis patients.Methods Eighty endometriosis patients were randomly allocated to a treatment group of 43 cases and a control group of 37 cases. The treatment group received fire needling and the control group took gestrinone capsules. CA-125 levels and EMAb were measured in the two groups before and after treatment.Results CA-125 levels and EMAb positive rate decreased significantly in the two groups after treatment compared with before (P<0.05) but there were no statistically significant post-treatment differences between the two groups (P>0.05).Conclusion Fire needling has a good interference effect on CA-125 levels and EMAb in endometriosis patients.

Adult ; CD56 Antigen ; metabolism ; Carcinoma, Papillary ; diagnosis ; metabolism ; pathology ; surgery ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; methods ; Female ; Humans ; Male ; Neprilysin ; metabolism ; Pancreatic Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Receptors, Progesterone ; metabolism ; Vimentin ; metabolism ; Young Adult ; beta Catenin ; metabolism

Objective To investigate the kinetic changes of inflammatory cell infiltration and thyroid autoantibodies in the development of iodine-induced autoimmune thyroiditis in NOD.H-2~(h4)mice.Methods Either 128 five-week-old NOD.H-2~(h4)mice or 128 Kunming mice were randomly divided into two groups,and received plain water or water containing 0.05% sodium iodide.At the time points of 1,2,4,8,12,16,and 24 week after receiving iodinated water,mice were anesthetized by diethyl ether and bled from eye socket vein,and their thyroid glands were collected.Indirect ELISA method was used to measure the levels of serum thyroglobulin autoantibodies (TgAb)and thyroid hormone.After being fixed with paraformaldehyde and embedded in paraffin,thyroid sections were stained with HE and used for morphometrieal analysis.Results In the iodine treated group of NOD.H-2~(h4) mice,autoimmune thyroiditis was observed as early as 1 week after they began receiving indinated water.The prevalence as well as the degree of autoimmune thyroiditis reached the maximum at 12 weeks and remained until 24 weeks.Serum TgAb level increased after 8 weeks of iodine ingestion in NOD.H-2~(h4) mice,then increased steadily throughout the 24 weeks of experiment.On the contrary,serum TgAb was not increased in the control group of Kunming mice.Conclusion Iodine may induce and exacerbate lymphocytic infiltration of the thyroid in genetically susceptible NOD.H-2~(h4) mice,and serum TgAb is just a marker of autoimmune thyroiditis.

Objective To observe the protective function of recombinant human thioredoxin(TRX) on HeLa cell injury induced by Coxsackie virus 3m(CVB3m) and to study the inhibiting effect of TRX on viral replication. Methods We infected HeLa cells with 10TCID50 CVB3m and then protected these cells with TRX (2,5,10 mg/L). The protective group of TRX, viral group, control group of TRX, and normal control group were included. Six parallel wells were set up in each group. The cell growth was observed by methyl thiazolyl tetrazolium(MTT) and contrast phase microscope. Results The results of contrast phase microscope revealed that HeLa cells were arranged tightly and polygon in normal control group; untightly, became circle and abscission in viral group; HeLa cells morphous improved by increasing TRX concentration in TRX protective group(2,5,10mg/L). MTT results of the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) control group(1.2%,2.9%,6.3%) were compared with normal control group(0), there was no significant difference(all P > 0.05); and while the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) protective group(32.0%,28.0%,27.0%) was compared with virus infective group(51.7%), there was a significant difference (all P < 0.05). The inhibition study of viral replication showed that compared the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) protective group(26.0%,27.0%, 10.9%) with virus infective group(60.0%), there was a significant difference(all P < 0.05). In the protective groups, there was a significant difference (all P < 0.05) between low dose groups(2,5 mg/L) and high dose groups( 10 mg/L). Conclusions The recombinant TRX(2,5,10 mg/L) may alleviate HeLa cell's injury induced by virus and the construct has no significant toxicity. TRX(2,5,10 mg/L) is effective in inhibiting virus CVB3m replication.

Objective To investigate the CT and MRI features and morphology classification of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B).Methods A total of 18 patients with IPMN-B proved by pathology were retrospectively analyzed.Out of 18 patients,16 patients underwent enhanced and non-enhanced CT,13 underwent contrast enhanced MR,and 11 out of 13 underwent both CT and MRI.IPMN-B was classified into 4 types:typical IPMN-B,cystic-forming IPMN-B,non-tumor IPMN-B and invasive IPMN-B,according to imaging findings and gross pathological findings.Results Typical IPMN-B (9 cases):tumors were distributed along the bile ducts,both upstream and downstream bile ducts were obviously dilated.Cystic-forming IPMN-B (5 cases):single or multiple tumors were found in aneurysmal dilatation of bile ducts.Non-tumor 1PMN-B (2 cases):no mass was found in the widely dilated bile ducts with smooth bile duct wall.Invasive IPMN-B (2 cases):tumors protruded into the dilated bile ducts causing jagged wall of bile duct,with accompanied abnormal density or signal intensity outside the bile ducts.Bile duct dilatations were shown in all 18 cases,and tumors were shown in 16 cases.In 2 cases no mass was displayed in widely dilated bile ducts.CT density of the tumor was lower than that of liver parenchyma,and higher than that of the bile and intraductal mucin.Signal intensity of the tumor was higher than that of stones,and lower than that of bile and intraductal mucin at MR T2WI.All tumors showed high intensity on DWI.Tumors showed mild to moderate enhancement after injection of contrast agent,CT density or signal intensity of the tumors were lower than that of the liver parenchyma during all three phases of contrast-enhanced CT or MRI.Conclusion IPMN-B has some specific CT and MR imaging features,which are helpful for the diagnosis and classification of IPMN-B.

OBJECTIVETo explore an optimal anesthesia method with less impact on hemodynamics and electrocardiogram (ECG) of old patients with coronary artery disease (CHD) during abdominal operation.

METHODSThe 133 CHD patients waiting for abdominal operation were randomly divided into continuous epidural anesthesia (EA) group, general anesthesia group (GA) and combined spinal-epidural anesthesia (CSEA) group. Continuous monitoring was carried out during operation and mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SaO2), abnormal ECG were measured respectively at different time for comparison and the differences of the above hemodynamic parameters and abnormal ECG features were compared among the 3 groups.

RESULTSAt the 15 min and 30 min point after anesthesia, SaO2 in GA group was significantly increased compared to that in the EA group (P < 0.05). At 15 min, 30 min and 60 min point after anesthesia, MAP in CSEA group was significantly increased compared to that in the EA group (P < 0.05). At 30 min point after anesthesia, HR in CSEA group was increased significantly compared to the EA group (P < 0.05). At 15 min and 30 min point after anesthesia, SaO2 in the CSEA group was increased significantly compare to the EA group (P < 0.05). Compared with preanesthesia (T0) in EA group, MAP, HR and SaO2 decreased significantly at 15, 30 and 60 min after anesthesia (P < 0.05). The fluctuation of the three parameters in GA and CSEA groups were relatively small (P > 0.05). As well as the comparison of abnormal ECG among the 3 groups was concerned, the incidence of ST-T changes in GA and CSEA groups were significantly lower than that in EA group at the time of 15 min, 30 min and 60 min after anesthesia and at the time of surgery termination (P < 0.05, P < 0.01). The incidence of arrhythmia in GA and CSEA groups were significantly lower than that in EA group at the time of 15 min, 30 min and 60 min after anesthesia (P < 0.05, P < 0.01). Compared with T0 in the same group, the incidences of ST-T changes and arrhythmia in GA or CSEA group at the time of 15, 30 and 60 min after anesthesia and at the time of surgery termination were significantly lower than that before anesthesia (P < 0.05, P < 0.01).

CONCLUSIONGA and CSEA have less impact on hemodynamics and have smaller incidence of abnormal ECG of old CHD patients with abdominal operation.

Aged ; Anesthesia ; methods ; Coronary Disease ; physiopathology ; Electrocardiography ; Female ; Hemodynamics ; drug effects ; Humans ; Male ; Middle Aged ; Perioperative Period

Aged ; Coronary Disease ; epidemiology ; Humans ; Myocardial Infarction ; epidemiology ; Perioperative Period

Objective To evaluate the effectiveness of one-stage debridement for cervical tuberculosis at different segments.Methods Clinical data of 54 patients (male 20,female 34) with cervical tuberculosis treated by one-stage debridement from Jan 1998 to Dec 2011 were reviewed retrospectively.The average age of these patients was 45.4 years (range,26-75 years).Among them,12 cases were involved in single level (C2 1 case,C4 2 cases,C5 3 cases,C6 4 cases,C7 2 cases); 36 cases in the adjacent two levels (C1,2 3 cases,C2,3 2 cases,C3,4 5 cases,C4,5 6 cases,C5,6 14 cases,C6,7 5 cases,C7T1 1 case); 5 cases in three levels(C4 6 2 cases,C5-7 2 cases,C3,5,6 1 case)and 1 case in four levels (C4-7).Five cases were involved in other spinal levels (T6 1 case,T 3 cases,L3,4 1 case).Comorbidity of cervical ossification of the posterior longitudinal ligament was found in 1 case.Before surgery,the mean VAS and JOA scores were 5.9 (range,4-9) and 10.5 (range,7-12) respectively and the mean Cobb angle of lesion segment was 26.7°± 9.1°.All cases underwent regular anti-TB treatment preoperatively,and surgical treatment were performed when blood sedimentation (ESR) was lower than 50 mm/1 h.According to the segmental involvement,different surgical approaches were performed including anterior debridement with anterior or anterior-posterior internal fixation and fusion,submandibular approach debridement with posterior occipital cervical fusion or atlantoaxial fusion.Results Mean follow-up duration was 27.3 months (range,13-52 months).Symptoms were improved significantly in all cases.Mean time of union was 3.2 months (range,2-4 months).At the last follow-up,the mean VAS and JOA scores were 5.9 (range,4-9)and 10.5 (range,7-12) respectively,and the mean Cobb angle of lesion segment was 6.8°.Regular anti-TB treatment was performed postoperatively for 18 to 20 months.Intraoperative esophageal injury was found in one case of upper cervical tuberculosis which was cured uneventfully after gastrointestinal tubation for 1 week.No cervical tuberculosis recurrence,graft loosening or pseudarthrosis was found in follow-up.Conclusion With preoperative anti-TB treatment,cervical tuberculosis can be treated by one-stage foci debridement according to the segmental involvement and deformity.Postoperative regular anti-TB treatment is a crucial factor for the final recovery of cervical tuberculosis.