[Objective]To discuss the relation-ship between AAONFH(advanced alcoholic osteonecrosis of femoral head)and extended overdose drinking.[Method]Reviewed 165 cases of total hip arthroplasty,to analyzed the clinical data among 27 AAONFH cases,reviewed the literatures,discussed the pathogenesis of AAONFH and the relation-ship between blood biochemistry and blood cloting funtion and compared the experimental results among literatures.[Result]Theres various factors resulted in osteonecrosis of the femoral head associated with alcohol long-term over intake.Individuals consuming more than 750 ml of alcohol daily were at greater risk of double or half ONFH,Theres no change in biochemical test,but blood clotting funtion in this case would degrade,osteoarthritis of hip would synchronize.[Conclusion]Individuals consuming more than 750 ml of alcohol daily have the potentiality of ONFH;Its no specificity significance in biochemical test,the necrosis extent of the femoral head is relative to the capacity and times of alcohol intake.THR(total hip replacement)is the best treatment for AAONFH,but theres more staxis potentiality in this cases.

Objective To analyze 206 cases of pregnant women with multiple organ dysfunction syndrome(MODS)due to different primary diseases and the prognosis.Method A retrospective study was conducted of 206 cases of pregnant women with MODS who were treated during January 2000 to December 2006 in the Third Affiliated Hospital of Guangzhou Medical College,regarding their primary disease and prognosis.Results Fourty-four cases among the 206 pregnant women with MODS died.The main primary causes were postpartum hemorrhage in 63 cases(30.6%),severe preeclampsia or eclampsia 60 cases (29.1%),pregnancy with hepatitis C in 23 case(11.2%),pregnancy with heart disease in 11 cases (5.3%),12 cases of ectopic pregnancy(5.8%).The mortality was mainly because of pregnancy complicated with heart disease(63.6%),ectopic pregnancy(41.7%),pregnancy with hepatitis (22.7%),of postpartum hemorrhage(17.5%)and severe preeclampsia-eclampsia(11.7%).The difference was statistically significant(P

Objective To observe the changes of plasma pulmonary surfactant protein-A (SP-A) and serum ferritin (SF) in neonates with mechanical ventilation and its clinical significance in ventilation-induced lung injury (VILI).Methods The study was carried out in 36 neonates with mechanical ventilation and 31 neonates without mechanical ventilation .Plasma SP-A and SF levels in venous blood were mea- sured on 1,24,48,72 hours after mechanical ventilation and 24 hours after mechanical ventilation removal by Western-dot blot and radioimmunoassay (RIA).Plasma SP-A and SF levels of non-mechanical ventilation group were determined at the same time.Results Plasma SP-A levels in neonates on 24,48,72 hours after mechanical ventilation were significantly higher than those of non-mechanical ventilation group[( 2.20? 0.22)vs(1.97?0.29) ?g/L,(2.43?0.28)vs(1.94?0.33) ?g/L,(2.61?0.38)vs(1.80?0.34) ?g/L,respectively P

Objective To explore change of RBC[Ca2+]i levels in neonates with hypoxic-ischemic encephalopathy(HIE)and the influence of nimodipine on RBC[Ca2+]i and its clinical significance.Methods Fifty-eight neonates with moderate and severe HIE were randomly divided into 2 groups including routine treatment group(n=28)and nimodipine group(n=30),and 20 healthy full-term neonates were selected as healthy control group.Based on the routine treatment,nimodipine[2 mg,0.5-1.0 ?g/(kg?min)] was given intravenously in the nimodipine group for 7-10 days.Blood samples were collected before and after treatment for 72 hours and 10-14 days,respectively.The levels of RBC[Ca2+]i were measured by Fura-2 pentakis(acetoxymethyl)ester[Fura-2/AM].The results were analyzed by SPSS 10.0 software.Results 1.The levels of RBC[Ca2+]i in neonates with HIE were significantly higher than those in healthy control group[(2.83?0.36)mmol/L vs(2.15?0.18)mmol/L,P

ObjectiveTo analysis the different types of bacteria in patients with a varying severity of acute cholangitis.Methods241 patients who presented with actue cholangitis between Jan 2008 to Oct 2011 to our hospital were retrospectively studied.These patients were divided into three groups according to the Tokyo Guideline.The bile specimens were obtained intraoperatively.The parameters were compared by SPSS 16.0 package program for statistical analysis.Results75.1 percent of the patients were positive for bacteria in the bile.There were 241 strains of bacterium which included 139 Gram-positive bacteria,99 Gram-negative bacteria and 6 strains of microzyme.Escherichia coli,Enterococcus faecalis,Enterococcus casseliflavus,Pseudomonas aeruginosa and Klebsiella species were the most frequently isolated bacteria.The positive rates for bacteria were significantly different between patients with mild and severe cholangitis (P＜0.05).There was no significant difference between patients with moderate and mild cholangits (P=0.141),or moderate and severe cholangitis (P=0.647).Gram-negative bacteria were more common than Gram- positive bacteria in patients with moderate and severe acute cholangitis (P＜0.05).In patients with moderate and severe acute cholangitis,there was more patients with multiple and mixed bacterial infection.ConclusionsEscherichia coli and Enterococcus species were more common in patients with acute cholangitis.The positive rate of bacteria in the bile in severe acute cholangitis was higher than that in mild acute cholangitis.In patients with moderate and severe cholangitis,Gram-negative bacterial infections and multiple and mixed bacterial infections were more common.

Objective To investigate the clinical significance of lymphatic mapping and sentinel lymph nodes (SLNs) biopsy in the diagnosis and treatment of gastric cancer. Methods A retrospective analysis was carried out based on the data of 46 patients who had received D2 gastrectomy from January 2003 to June 2006. The SLNs stained by methylene blue were resected for biopsy. Results The success rate of SLNs biopsy was 83% (38/46). The sensitivity, false-negative rate, accuracy, specificity, negative predictive value and positive predic-tive value of SLNs were 69% (18/26), 31% (8/26), 79% (30/38), 100% (12/12), 60% (12/20) and 100% (12/12). The sensitivity, accuracy and negative predictive value were 100% in patients with tumor in pT1 stage or TNM I stage, or with the diameters of the tumors under 4 era. The tumor site, and the degree of lymph node metastasis affected the success rate of biopsy, and the invasion depth, clinical stage and the degree of lymph node metastasis affected the sensitivity, accuracy and negative predictive value of biopsy. Conclusions The application of sentinel lymph node biopsy using methylene blue in gastrie cancer is feasible. The sensitivity, accuracy and reliability are high in patients at early stage of gastric cancer.

Adenocarcinoma ; surgery ; Adenoma ; surgery ; Adult ; Aged ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; surgery ; Hemangioma ; surgery ; Humans ; Ileal Neoplasms ; surgery ; Jejunal Neoplasms ; surgery ; Laparoscopy ; methods ; Lymphoma ; surgery ; Male ; Middle Aged

BACKGROUND: The degree of neurofilament (NF) phosphorylation is closely correlated with the occurrence of Alzheimer disease (AD), and apolipoprotein E4 (apoE4) is a generally acknowledged liability factor for AD, but the effect and mechanism of apoE4 on the NF phosphorylation in neurons are not very clear. It has been reported that in the neurons cultured in vitro and in brain tissue of AD patients, the amino acid residues of apoE4 protein C terminal (272-299) could be truncated by hydrolysis,and produce truncated-apoE4 fragment. The latter interacts with the NF phosphorylation in neurofibrillary tangles (NFTs), which are the characteristic pathological changes of AD.OBJECTIVE: To observe the effect of truncated-apoE4 overexpression on the NF phosphorylation in the cultured neurons.DESIGN: A non-randomized controlled observation.SETTING: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was carried out in the Laboratory of Biochemistry and Molecular Biology, Tongji Medical College, Huazhong University of Science and Technology in December 2005. The mice neuroma cell strain N2a was provided by Dr. Xu.METHODS: The truncated-apoE4(△272-299) cDNA was subcloned into pEGFP-c3 to form pEGFP-T-apoE4 recombinant. Then pEGFP-c3, pEGFP-apoE4 and pEGFP-T-apoE4 were transfected into N2a cells by lipofectamine2000 respectively. NF phosphorylation was detected by Western blot assay. The activities of glycogen synthase kinase-3 (GSK-3) and cyclin-dependent kinase 5(CDK-5) were measured.MAIN OUTCOME MEASURES: The degree of NF phosphorylation and the activities of GSK-3 and CDK-5 were mainly observed.RESULTS: In the transfected groups, the contents of phosphorylated NF were significantly increased, the GSK-3 activities were significantly increased, which were the most significant in the pEGFP-T-apoE4 transfected group (P＜0.05), but the CDK-5 activities were not significantly different from that in th e control group (P＞0.05).CONCLUSION: These results indicate that in vitro overexpression of truncated-apoE4(△272-299) can lead to NF hyperphosphorylation by activating of GSK-3 but not CDK-5, which may be the underline mechanism of AD induced by truncated-apoE4(△272-299).

Objective:To evaluate the acute oral toxicity , skin irritation and skin allergy of Thuja essential oil ( TEO) , and pro-vide experimental basis for the clinical use of TEO .Methods:The acute oral toxicity was measured by Horn ’ s assay .Totally 40 KM mice were divided into four groups and intragastrically administered with TEO at different dose of 21.50, 10.00, 4.64 and 2.15 g · kg-1 .After the 14-day observation, the death number and toxic manifestations were recorded and observed , and LD50 was calculated by checking the Horn's form of LD50 .The skin irritation test was performed on healthy adult white rabbits .Totally 9 rabbits were divid-ed into 3 groups randomly , and TEO at the concentration of 100%, 50%and 25%was painted on the skin of the rabbits .Edible vege-table oil was used as the negative control .The erythema and edema of the treated skin were evaluated and scored .Delayed skin hyper-sensitivity reaction was used to investigate the allergy of TEO .Totally 30 white guinea pigs were randomly divided into 3 groups:TEO group, the negative control (edible vegetable oil) and the positive group (1%2, 4-dinitrochlorobenzene).After the intracutaneous in-duction stage and local induction stage , TEO was used to activate the hypersensitive reaction .The skin response was observed and scored after the 24-hour and 48-hour activation.Results:The mice in 21.50 g · kg-1 TEO treatment group were all dead , while only a part of the mice in 10.00 and 4.64 g · kg-1 TEO treatment groups were dead , and no mice died in 2.15 g · kg-1 TEO treatment group.According to the Horn's form of LD50 , LD50 of TEO was 9.26 g · kg -1 for male mice and 7.94 g · kg -1 for female mice.The results of skin irritation test indicated the strong irritation effects of TEO .However , the irritation of TEO was reduced after the dilution , and 25%TEO showed no irritation to the skin of rabbits .The results of delayed skin hypersensitivity reaction showed obvious erythema and edema induced by 2, 4-dinitrochlorobenzene , while no obvious erythema and edema were found in TEO treated guinea pigs , indi-cating non-allergic effect of TEO .Conclusion:TEO has strong skin irritation in rabbits , while no obvious oral toxicity in mice and skin allergy in guinea pigs .

Objective To analyze the experience of 745 cases of lumbar disc herniation(LDH) and investigate the relevance between the clinical symptoms,signs and operative observation.Methods From 1982 to 2003,745 cases of LDH were treated operatively.In order to investigate the relationship between clinical presentations and operative results,a statistic analysis was conducted using the clinical symptoms,signs and operative observations.Results As the predominant manifestions,the pain in the low back and leg was seen in 96.4% of LDH,the pain aggravated by belly pressure in 93% of LDH,local tenderness and radicular pain around the lumbat spinous process in 70.8% of LDH,rectoleg elevation test(+) in 91.6% of LDH.operation observation:77.6% of LDH was classified as lateral type,10.9% as medial type and 11.5% as rupture or sequestration type.Weakness of extensor hallucis longus could seen in 65.6% of LDH of L_4,L_5,in 32.3% of LDH of L_5S_1.Conclusions Although the extensive usage of computed tomography(CT) and magnetic resonance imaging(MRI) provides a prompt and accurate basis for diagnosis of LDH,the physical examination remains the most important routine way to make a diagnosis.It is suggested that during the diagnosis and treatment of LDH,besides the common features of the disease,some individual presentations should not be neglected in few rare atypical cases,so as to diagnose and treat correctly.