Objective By analysis oflateralepicondylitis patients MRI features to explore the lateralepicondylitis namedrationality and authorized its opinions for the ninth edition surgery textbook. Methods Cochrane's systematic review methods were used to retrieve the literature about lateralepi-condylitis patients MRI features fromCochrane Library, Medline, OVID, EMBASE, Chinese biomedical literature database (CBM), VIP, CNKI, Wan fang digital journals, and totally 31 articles were reviewed. 13 articles met the inclusion criteria for the lateral epicondyle of humerus elbow in patients with MRI findings. In accordance with the case-control data RevMan 5.0 software was used for Meta analysis withodds ratio (OR) as count data statistics. Interval estimation wasmade of 95% confidence interval (CI). When the datacannot be performed Meta analysis, only qualitative analysis was made. Results 13 studies met the inclusion criteria, including 315 ipsilateralelbows (5 patients with bilateral disease, 305 patients with unilateral disease) and 169 asymptomatic side of the elbow (98 cases of patients with the contralateral elbow, 71 cases of healthy volunteers). The results of Meta analysis suggested that pa-tients and healthy volunteers of elbow MRI showed statistically significance [OR=88.55, 95%CI=(29.20, 268.57)]. Between ipsilateral elbow and contra lateral of elbow MRI showed statistically significance [OR=80.17, 95%CI=(21.53, 298.59)]. MRI analysis showed that in addition to signs of extensor tendon injury, the elbow was also widely associated with other changes, such as radial collateral ligament in-jury, bone marrow edema, joint effusion, tendon tear, and elbows muscle edema. Conclusion Through MRI findings,the maln pathological changes of the so-called lateralepicondyliti-saremalnly for total ex-tensor tendon and adjacent tissue of chronic injury, Naming the current external humeral epicondylitis is unreasonable. Therefore, periarthritis of lateral epicondyle of humerus seems to be the best appropri-ate term to be usedwhenthe ninth edition surgery textbooksisauthorized.

ObjectiveTo investigate the rule of changes of the soleus mass and expression of myosin heavy chain (MHC) isoforms mRNA.Methods40 female Wistar rats were divided randomly into the control group and three spinal cord transection (ST) groups, ST7, ST15, and ST30 with 10 animals in each group. Rats in ST groups were subjected to a complete ST between T8 and T10 levels. The right soleus was dissected and weighed at 7, 15, 30 days after ST, and the expression of MHC mRNA isoforms was measured by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR).ResultsThe Absolute and relative soleus masses in three ST groups were lower significantly than those of control group (P<0.05). The soleus mass in ST15 and ST30 groups were lower than that of ST7 group (P<0.05). The soleus of control group predominantly expressed MHC-I and some MHC-IIa, whereas the soleus began to express MHC-IIx and MHC-IIb after ST, except for MHC-I and MHC-IIa. ST induced consistently down-regulation of MHC-I mRNA and up-regulation of MHC-IIx and MHC-IIa at three time points after ST. The level of MHC-IIb mRNA expression was very low at three time points after ST.ConclusionST can influence the soleus mass at early stage after ST. ST induces a shift toward a faster muscle phenotype from slow to fast MHC isoform. MHC demonstrates plasticity in response to decrease neuromuscular activation.

OBJECTIVETo evaluate therapeutic effect of acupuncture at Sifeng (EX-UE 10) on infantile malnutrition.

METHODSMulticentral, randomized, controlled and single blind test was adopted. 222 infants of malnutrition were divided into an acupuncture group (n=110) and a medicine group (n=112). The acupuncture group were treated with acupuncture at bilateral Sifeng (EX-UE 10), once each week, for 4 times; and the medicine group were treated with oral administration of Yiqi Jianpi Oral Liquid, twice each day, one ample each time, for 4 weeks. The therapeutic effect was evaluated by improvement of symptoms and signs in the syndrome cumulative score scale, and changes of serum insulin-like growth factor-I (IGF-I), pre-albumin (PA), hemoglobin and red-cell count.

RESULTSTwo hundred and twenty-two cases were enrolled in the 4 centers and 212 cases completed the test. The acupuncture group in improvement of appetite, body weight, subcutaneous fat thickness of the abdomen, etc. were superior to the medicine group (P < 0.01), but there was no significant difference between the two groups in improvement of the body height. There was no significant increase of serum IGF-I level in the two groups, and the acupuncture group in increase of PA was superior to the medicine group (P < 0.05). After treatment, hemoglobin and red-cell count increased significantly in the treatment group (P < 0.01), and hemoglobin increased significantly in the medicine group.

CONCLUSIONAcupuncture at Sifeng (EX-UE 10) has obvious therapeutic effect on infantile malnutrition.

Acupuncture Points ; Acupuncture Therapy ; Appetite ; Humans ; Infant Nutrition Disorders ; Single-Blind Method ; Treatment Outcome

OBJECTIVETo explore the role and mechanism of oxidative inflammatory cascade in pancreatic fibrosis progression of chronic pancreatitis (CP) in mice induced by dibutyltin dichloride (DBTC) plus ethanol.

METHODSThirty-six KM mice were randomly divided into 2 groups (n = 18): control group and model group (DBTC combined with ethanol). The mice in model group were intravenously injected with DBTC (8 mg/kg) in tail vein and drink 10% ethanol. After modeling 2 weeks, 4 weeks and 8 weeks, the mice were anesthetized and sacrificed, the pathological changes and the degree of fibrosis in the pancreas were observed by HE and Masson staining, the F4/80 expression level were detected by immunohistochemistry, the content of superoxide dismutase (SOD), malondialdehyde(MDA) and myeloperoxidase (MPO) were measured in the pancreatic homogenates.

RESULTSThe fibroblasts and macrophages (f4/80 positive staining) could be seen obviously in pancreas of model group at 2 weeks. At 4 weeks and 8 weeks, macrophages infiltration increased and pancreatic tissue was substituted by the proliferation of fibrosis significantly. At every time-point, in pancreatic homogenates SOD was decreased, MDA and MPO markedly increased. There was significant differences between two groups (P < 0.05).

CONCLUSIONDBTC injection joint ethanol drinking can successfully establish the model of chronic pancreatitis and pancreatic fibrosis in mice. Oxidative inflammatory cascade plays an important role in the progression of pancreatic fibrosis.

Animals ; Disease Progression ; Ethanol ; adverse effects ; Fibrosis ; Immunohistochemistry ; Malondialdehyde ; metabolism ; Mice ; Organotin Compounds ; adverse effects ; Oxidative Stress ; Pancreas ; pathology ; Pancreatitis, Chronic ; chemically induced ; physiopathology ; Peroxidase ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the impact of 1, 25-(OH)2D3 on left ventricular hypertrophy (LVH) in type 2 diabetic rats.

METHODSType 2 diabetic mellitus (DM) model rats were established by intraperitoneally injecting with 30 mg/kg streptozotocin. After 8 weeks, 19 male rats were identified as diabetic with left ventricular hypertrophy (LVH) by ultrasound examination, and randomly assigned into three groups: untreated (DM-LVH, n=7), treated with insulin (DM-LVH+INS, n=6), and treated with 1, 25-(OH)2D3 (DM-LVH+VD, n=6). Healthy male rats were used as the controls group (n=6). The fasting blood glucose and the insulin level were determined weekly. The left ventricular mass index, myocardial collagen content, collagen volume fraction, and 1, 25-(OH)2D3-receptor level were determined by 4 weeks later.

RESULTSIn the DM-LVH model group, the insulin level was significantly decreased compared with the non-diabetic control group (P<0.05), whereas the blood glucose, left ventricular mass index, myocardial collagen content, collagen volume fraction, and 1, 25-(OH)2D3-receptor expression were significantly increased (all P<0.05). In the DM-LVH+INS and DM-LVH+VD groups, the insulin levels were significantly increased compared with the DM-LVH model group (P<0.05), whereas the other parameters were significantly decreased (all P<0.05).

CONCLUSION1, 25-(OH)2D3 could reverse LVH in diabetic rats and that the mechanism may involve stimulating insulin secretion and reducing blood glucose via direct up-regulation of 1, 25-(OH)2D3-receptor expression.

Animals ; Blood Glucose ; analysis ; Calcitriol ; therapeutic use ; Diabetes Mellitus, Experimental ; blood ; complications ; Diabetes Mellitus, Type 2 ; blood ; complications ; Hypertrophy, Left Ventricular ; prevention & control ; Insulin ; blood ; Male ; Rats ; Rats, Wistar ; Receptors, Calcitriol ; analysis ; Streptozocin

Objective To investigate the epidemiology of bacterial infections after liver transplantation and anaIyze the antimi- crobial susceptibility of major pathogens to provide reference for clinical therapy.Methods A retrospective survey was conduc ted in 174 patients who underwent liver transplantation during 2001 and 2004.Identification and susceptibility of pathogens were assayed by Microscan Walkaway 40 Automatic System.Results Infection was identified in 59.8% of the 174 patients after liver transplantation.A total of 218 non-duplicate strains were isolated.Most infections were caused by single pathogen.The infection was frequently identified in respiratory tract,biliary tract,blood stream or intra-abdominal cavity.The top 5 patho- gens were Acinetobacter baumannii,Staphylococcus aureus,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Escherichia coli.Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to piperacillin- tazobactam or imipenem.Most of S.aureus isolates were methicillin-resistant,which were susceptible to vancomyein.Conclu- sions Pathogens of postoperative infections in liver transplantation recipients are mostly multi-drug resistant.The microbiologi- cal surveillance is important for guiding clinical therapy.

AIM To observe the clinical effects and safety of Zibei Zhike Granules (Asteris Radix et Rhizoma,Ardisiae japonicae Herba,Fritiliariae cirrhosae Bulbus,etc.) for acute broncho-bronchitis with remained toxicity lingering lung.METHODS A multi-center,randomized,double-blinded,double-simulation and positive drug parallel controlled trial was adopted.Two hundred and forty cases of patients with the 1 ∶ 1 ratio were assigned to treatment and control group.The treatment group were treated with Zibei Zhike Granules and the control group were treated with Zikebao Tablets (Asteris Radix et Rhizoma,Citri rubrum exocarpium,Platycodi Radix,etc.).The treatment course lasted five days.RESULTS The total effective rate of acute broncho-bronchitis in the treatment group was 73.04％,and 54.78％ in the control group.There was statistical significance between the total effective rate of the two groups (P ＜ 0.01).The total effective rate of traditional Chinese medicine syndrome in the treatment group was 73.91％ and 60.86％ in the control group,and there was statistical significance between the total effective rate of the two groups (P ＜ 0.05).The treatment group showed better clinical effects in improving individual symptoms of cough and spitting sputum.CONCLUSION Zibei Zhike Granules has good clinical effects on acute broncho-bronchitis.

Background Fundus photography is a traditional method for detecting local retinal nerve fiber layer (RNFL) defects,but the evaluation of its result depends on the observer's experience.The spectral domain optical coherence tomography (OCT) exhibit the defects of RNFL very clearly.Objective This study was to evaluate the diagnosis value and correlation between topographic profiles of localized RNFL defects determined by spectral domain and time domain OCT with fundus photography.Methods Forty-one normal eyes of 41 subjects and 55 eyes of 55 glaucomatous patients with localized,wedge-shaped RNFL defects identified by two glaucoma specialists in fundus photographs were enrolled in the clinical study.The angular location and width of RNFL defects determined on the images of fundus photography,Cirrus HD-OCT and Stratus OCT were analyzed respectively using Pearson's correlation coefficient and linear regression analysis.This study followed the Helsinki declaration and was approved by Ethic Committee of Shenzhen Eye Hospital.Written informed consent was obtained from each individual before the clinical examination.Results Seventy-five RNFL defects were identified in 55 eyes by two glaucoma specialists unanimously with the defect position at superior-temporal and inferior-temporal quadrants.The sensitivity of Cirrus HD-OCT and Stratus OCT to determining RNFL defects were 88.0% and 69.3% respectively and their specificities were 92.7% and 97.6% respectively.The angular locations of RNFL defects by Cirrus HD-OCT and Stratus OCT were highly correlated with those by fundus photography(r=0.993,r=0.992,P＜0.001);while the angular widths of RNFL defects by Cirrus HD-OCT and Stratus OCT were moderately correlated with those by fundus photography(r=0.420,r=0.432,P=0.019,P=0.002).No significant differences were found in the defect width of RNFL between Cirrus HD-OCT or Stratus OCT and fundus photography(Cirrus HD-OCT:P=0.114;Stratus OCT:P=0.074),and significant difference was found in that between Cirrus HD-OCT and Stratus OCT(P=0.002).Conclusion Spectral domain OCT and time domain OCT can localize RNFL defects with high sensitivity and specificity.The measure value of Cirrus HD-OCT and Stratus OCT for RNFL defects shows a good diagnostic agreement with fundus photography.

Background Glaucoma is primarily characterized by the damage of retinal ganglion cells.The macular ganglion cell complex (GCC)thickness can be quantitatively measured using spectral domain optical coherence tomography(SD-OCT). Objective This clinical study was to explore the macular GCC thickness change in primary open-angle glaucoma (POAG) patient with SD-OCT. Methods A serial case-controlled study was designed.A total 101 eyes of 101 POAG patients and 41 normal eyes of 41 age- and refract power-matched normal subjects were cnrolled in the study.POAG patients were assigned to normal perimetry POAG group,early stage POAG group,advanced POAG group and late stage POAG group.Average macular GCC thickness(GCC-Avg),superior GCC thickness(GCC-Sup) and inferior GCC thickness (GCC-Inf)of subjects were measured by SD-OCT and compared among POAG patients and normal controls.Peripapillary retinal nerve fiber layer(RNFL) thickness was measured with time domain OCT(TD-OCT).The correlation between GCC thickness with RNFL thickness or mean deviation(MD) of perimetry were evaluated and analyzed.Informed consent was obtained from each patient prior to entering this study.Results GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the normalperimetry POAG group and early stage POAG group compared with the normal control group (GCC-Avg:t =5.411,10.247,P ＜ 0.01 ; GCC-Sup:t =6.171,9.484,P＜ 0.01 ; GCC-Inf:t =5.281,8.592,P ＜ 0.01 ).Also,GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the advanced POAG group compared with the early stage POAG group ( GCC-Avg:t =4.246,P＜0.01 ; GCC-Sup:t - 2.419,P - 0.019 ; GCC-Inf:t =4.636,P＜0.01 ),and GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the late stage POAG group compared with the advanced POAG group (GCC-Avg:t=2.095,P=0.040;GCC-Sup:t=2.756,P＜0.01:GCC-Inf:t =2.018,P =0.040 ).The positive correlations were seen between GCC-Avg thickness,GCC-Sup thickness,GCC-Inf thickness and RNFL-Avg thickness,RNFL-Sup thickness,RNFL-Inf thickness respectively( r =0.802,0.825,0.856,P ＜ 0.01 ).MD value of perimetry was positive correlated with GCC-Avg thickness in POAG patients ( r =0.601,P ＜ 0.01 ). Conclusions SD-OCT can quantitatively measure and differentiate the GCC thickness in POAG patients.The GCC thickness gradually decreases with the development of POAG.There exist a well correlation between visual field defect and RNFL thinning.

The clinical characteristics of patients who presented in poor clinical grade due to ruptured middle cerebral artery aneurysms (MCAAs) associated with large sylvian hematomas (SylH) were analyzed and an ingenious designed prophylactic hinged craniectomy was introduced. Twenty-eight patients were graded into Hunt-Hess grades IV-V and emergency standard micro-neurosurgeries (aneurysm clipping, hematoma evacuation and prophylactic hinged craniectomy) were performed, and their clinical data were retrospectively analyzed. 46.43% of the patients reached encouraged favorable outcomes on discharge. The favorable outcome group and the poor outcome group significantly differed in terms of patients' anisocoria, Hunt-Hess grade before surgery, extent of the midline shift and time to the surgery after bleeding (P<0.05). There were no significant differences in age, sex, volume and location of the hematoma, size of aneurysm between the favorable and poor groups (P>0.05). However, ingenious designed prophylactic hinged craniectomy efficiently reduced the patients' intracranial pressure (ICP) after surgery. It was suggested that preoperative conditions such as Hunt-Hess grading, extent of the midline shift and the occurrence of cerebral hernia affect the prognosis of patients, but time to the surgery after bleeding and prophylactic hinged craniectomy are of significant importance for optimizing the prognosis of MCAA patients presenting with large SylH.