To evaluate the diagnosis and treatment of epidural neurilemmoma in the spinal canal, the diagnostic characteritics shown by X ray, MRI and CT were analyzed in 42 patients. Furthermore, peri operative conditions, operative time, blood loss and amount of blood transfusion during the operation, operative technique, changes in functions of the spinal cord before and after the operation were also analyzed. The results showed that there was marked recovery of nerve functions after the operation. MRI together with X ray and CT were in the diagnosis of the nature and site of the lesion. Excision of the tumor was done in all the patients. Among them, in 12 patients internal fixation was done at the same time. Follow up showed that the operation achieved good results. While radiologic examinations contributed greatly to the diagnosis, the final diagnosis depended on pathological examination. Internal fixation was optional depending on different situations.

Objective To analysis the clinical characteristics of kidney transplantation for the aged recipients and the influence of quadruple immunosuppressant on treatment result. Methods From 1990 to 2001,of 1251 cases of renal transpantation,the clinical data of 126 cases of the aged recipients over 60 years old were investigated.The aged recipients was divided into two groups;combination of cyclosporine(CsA),azathoprine(Aza) and corticosterioids was given in groupⅠ,In groupⅡ,except for CsA,mycophenolate mofetil(MMF),corticosteroids and Wu-T 3 quadruple therapy in the 47 cases aged recipients, Daclizumab or Basiliximab were injected in prophylaxis of acute rejection within 2 hours prior to transplantation and in someday after transplantation to the 24 aged recipients. The groupⅡ was compared with the groupⅠ in complications, the rate of acute rejection and the one-year-survival rate of patients/allograft.Results The rates of cardiocerebral vascular disease and infection complications in the aged recipients were higher than that in the non-elderly patients. In the groupsⅠ and Ⅱ, the postoperative complications was 74 55%and 38 03%, respectively;the rates of acute rejection were 12 73% and 4 23%,respectively;one year survival rate of patients/allografts was 81 82%/78 18% and 97 18%/95 77% respectively.Conclusions The cardiocerebral vascular disease and infection complications were the main factors affecting the outcome of renal transplantation in the aged recipients. The quadruple immunosuppressant regimens could reduce postoperative complications and acute rejection. At the same time one-year-survival rate of patients/ allografts have been improved in the aged patients.

Objective To observe the protective effects of enalapril on the long-term functions of the allograft in renal transplant recipients. Methods Twenty renal transplant recipients with ~survival time over one year, normal renal functions of the allograft and urine TGF-?_1 levels being more than ~250.0 pg/mg.Cr took enalapril every day for at least one year. Twenty-three recipients under the same conditions who did not receive enalapril served as control group. Three years later renal ~dysfunction cases, loss of creatinine clearance rate (Ccr) and TGF-?_1 levels in blood and urine were compared between the two groups. The changes in the expression of TGF-?_1mRNA in renal biopsy specimens were compared before and one year after enalapril therapy. Side-effects of enalapril were ~investigated in all patients in enalapril-treated group. Results Three years later, the number of renal dysfunction cases was less, the loss of Ccr was less and the level of urine TGF-?_1 was lower in ~enalapril -reated group than those in control group with the differences being significant (P~0.05 ). One year after enalapril therapy TGF-?_1mRNA expression was significantly decreased in renal biopsy specimens (P

Cause of Death ; Female ; Hospital Mortality ; Hospitalization ; statistics & numerical data ; Humans ; Infant, Newborn ; Inpatients ; statistics & numerical data ; Male

Objective To study pathogensand diagnostic value of beta2-microglobulin(?2-MG) in cerebrospinal fluid(CSF) in children with aseptic meningitis(AM).Methods Polymerase chain reaction (PCR) or reverse transcription-PCR (RT-PCR) assay,enzyme linked immunosorbent assay (ELISA) and passive particle agglutination were employed respectively to detect herpes simplex virus type-1(HSV-1) DNA,enterovirus(EV) RNA in CSF and the specific antibodies of HSV-1 and mycoplasma pneumonia(MP) in blood and CSF from 80 children with AM (AM group) and 20 cases of complete remission acute leukaemia(control group).Children with AM were divided into the EV meningitis group,HSV-1 meningitis group and MP meningitis group according to respective diagnostic criteria.The levels of ?2-MG in CSF from all groups were detected by radio immunoassay.SPSS 13.0 software was used to analyze the data.Results The infection rate of EV,HSV-1 and MP were 52.5%,11.25%and 5.0%,respectively in children with AM.The infection rate of EV was highest.The sensitivity of PCR was higher than ELISA.There could be false negative PCR results in bloody CSF specimens with HSV-1 DNA.The levels of ?2-MG in CSF was significantly higher in children with AM than that in control group(P

Accidents, Occupational ; Adult ; Dichloroethylenes ; poisoning ; Female ; Humans

Background Vancomycin has been increasingly recommended for the management of endophthalmitis,but few research report has been published about the pharmacokinetics of intravitreal vancomycin up to now.It is necessary to have an exact method to measure the concentration of vancomyein in animal eyes after intravitreal injection.Objective This study was to observe and compare the phamacokinetical process of vancomycin in serum,vitreous and aqueous humor between normal and infected rabbit eyes.Methods Seventy-two healthy adult rabbits were randomly divided into normal group and infected group and 36 rabbits for each.The animal models of endophthalmitis were established by intravitreal inoculation of 2000 CFU/ml staphylococcus aureus in the right eyes of rabbits in the infected group.Once endophthalmitis developed,0.1 ml vancomycin ( 10 g/L) solution was injected into the vitreous of every rabbit.The peripheral blood,vitreous and aqueous humor samples were respectively collected in 4 rabbits for each group at 0.5,2,4,6,12,24,48,72 and 84 hours after injection for detection of vancomycin concentration by high performance liquid chromatography(HPLC-UV).3p97 software was used to create fit parameters of pharmacokinetics.This experiment followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission (Version 1988).Results The accuracy of HPLC fitted the detecting request of biological specimen.The concentration-time data of vancomycin in normal rabbit aqueous humor and vitreous was subject to two-compartment model.The pharmacokinetic parameters were separately as following:Cmax was 50.16 mg/L and 751.42 mg/L,t1/2was 51.04 hours and 53.21 hours.The concentration-time data of vancomycin in infected rabbit aqueous humor and vitreous was subject to one-compartment model.The pharmacokinetic parameters were separately as following:Cmaxwas 24.94 mg/L and 687.66 mg/L,t1/2was 11.42 hours and 12.91 hours.The concentration of vancomycin in serum was much lower and almost undectable.The concentration of vancomycin in vitreous was gradually reduced as the prolong of time after injection in both normal group and infected group,but a obvious decline after increased level was scen in aqueous humor.Compared with normal group,the concentrations of vancomycin in both vitreous and aqueous humor were reduced at various time points(P＜0.05,P＜0.01 ).Conclusions HPLC is simple,highly sensitive and specific for the pharmacokinetic analysis of vancomycon.These results indicate that pharmacokinetic parameters of vancomycin alter in pathological condition,which is helpful for us to establish the better treatment guidelines for endophthalmitis.

Objective To discuss the Clinical character of pulmonary tuberculosis combined malignant lymphoma and its Pathogenesis,and to review the literature.Methods Eighteen cases of pulmonary tuberculosis combined malignant lymphoma from 1996 to 2003 were retrospectively analyzed by its clinical manifestations,X-ray features,diagnosis and treatments.Results 18 cases were all infiltrative pulmonary tuberculosis,13 them were calcification focals,5 were active pulmonary tuberculosis;5 of all were Hodgkin’s lymphomas,13 of all were non-Hodgkin′s lymphomas.16 cases were lymphomas after tuberculosis,2 cases tuberculosis after lymphomas,none were co-existent malignant lymphoma and tuberculosis.Tuberculosis may precede or complicate a lymphomatous process during the development of both diseases,This might is linked to immune deficiency and chronic inflammation;Lymphomas might cause pulmonary tuberculosis,it might cause the immune turbulence of an individual,Pulmonary tuberculosis infection occurring during or after the radiotherapy and chemotherapy of lymphoma.Conclusions It may pulmonary tuberculosis combined malignant lymphoma in the patients in the endemic areas of tuberculosis,Appropriate invasive biopsy procedures are necessary for early diagnosis.

Objective To explore the protective effect of astragalus injection(黄芪注射液)on cerebral cells after craniocerebral injury.Methods Sixty male Sprague-Dawley(SD)rats were randomly divided into five groups(each n=12).In the control group,only anesthesia and cranial bone surgery was performed, which did not impact on dura mater.In the model group,a freefall method was used to cause the left parietal lobe of brain limited contusion and saline was given.In the low,medium and high-dose astragalus injection (5,10,20 ml/kg)treatment groups,astragalus injection was injected intraperitoneally after injury at 30 minutes and 12 hours after injury respectively.After 24 hours of injury in each group,the rats were executed.The brain tissue from contusion was taken out and content changes of Ca~(2+),Mg~(2+),glutamate (Glu)and plasma endothelin(ET)were measured.Results In the model group,the Ca~(2+),Glu and ET contents in the rat brain tissues were significantly higher,but Mg~(2+)content was markedly lower than that of the control group(all P0.05).Conclusion Astragalus has a protective effect on nerve cells after craniocerebral injury.

Objective To identify mutations site and clinical characteristics of a familial hypercholesterolemia(FH) proband diagnosed clinically through DNA sequencing and family analysis in the proband and his family members of 3 generations.Methods Blood samples and clinical data of the kindred of total 29 from 3 generations members were collected.Proband had a physical examination electrocar-diogrom and vascular ultrasound.The proband and his family members took routine clinical exams,and genomic DNA was isolated.The promoter region and the 18 exons of low density liporotein receptor(LDLR) gene were screened by Touch down polymerase chain reaction -single strand conformation polymorphism(PCR-SSCP) and DNA sequencing.The result of sequencing were matched gene sequence published in the BLAST database.Results 1.Increased intima-media thickness and plaque were detected in the common carotid artery,right subclavian artery of the proband.Aortic valve regurgitation was found by echocardiography.2.No mutation R3500Q of ApoB100 was observed.3.Two heterozygous mutations in exon 10 and 13 of LDLR gene (W462X and A606T) were identified.The proband and 5 members of paternal relatives showed W462X heterozygosis mutation in exon 10 of LDLR gene which introduced the change from tryptophone to a new stop codon.The proband's mother and grandmother harboured A606T heterozygous mutation in exon 13 of LDLR gene due to a single base pair substitution of G for A in the codon for residue 1 879.Conclusions Disease causing mutations of proband are W462X and A606T compound heterozygosis mutation in exon 10 and 13 of LDLR gene inherited from mother and father.Proband shows homozyous phenotype though the genotype analysis indicates heterozygous mutations.