Hormones and epigenetic characteristics in a patient with clinically diagnosed adrenal hypoplasia congenita (AHC) were analyzed. Results indicated that plasma ACTH increased, while cortisol, testosterone, LH and FSH decreased. LH, FSH and testosterone did not sufficiently respond to GnRH or hCG stimulation. Gene analysis indicated that C368F mutation was located in exon 1 of DAX-1 gene.

Objective To improve the diagnosis and treatment of ureteral cancer. Methods A retrospective analysis of 24 cases of primary ureteral cancer treated from January 1990 to March 2005 was performed.The diagnostic value of ultrasound,IVU,CT,MRU and the patients' outcomes were reviewed. There were 19 males and 5 females aged 38-72 years(mean,59 years).The tumors were on the left side in 16 cases and on the right in 8.Of the 24 cases,17(71%)had gross hematuria and 7(29%)had micro- scopic hematuria.Urine cytology was performed in 16 cases with a positive rate of 6.3%.B-ultrasonic exami- nation showed hydronephrosis in 19 cases(79%)and low-echo space-occupying disease of middle-inferior ureter in 3(12%).IVU demonstrated hydronephrosis in 20 cases(83%)and filling defect of the diseased ureter in 3(12%).Retrograde pyelography showed filling defect of the diseased ureter in 16(76%)of 21 cases(5 cases had failure of intubation).CT scan was performed in 20 cases,indicating thickening of the ureteral wall and infiltration of the cancer in 14(70%).In 3 cases who had undergone spiral CT thin layer scan and 1 of 3 cases who had undergone MRU,the definite diagnosis was made.Results All the 24 pa- tients underwent surgical treatment.Among them,nephroureterectomy and bladder cuff or partial resection were performed in 18 cases,and nephrectomy and partial ureterectomy in 6 cases.Postoperative pathology showed transitional cell carcinoma in 23 cases,and adenoma in 1.Of the 14 cases during 1990-1999 peri- od,1,5,3,2,2 and 1 cases had survival time of 1,2,3,4,5 and 6 years,respectively.Of the 10 cases during 2000-2005 period,3 were lost to follow-up;2 survived for 3 years and 2,for 1 year;the other 3 who have survived near 5 years have been followed till now.Conclusions IVU and retrograde urography are the most common diagnostic measures for primary ureteral cancer.They can be used in combination with other imaging study to reduce missed diagnosis rate.The 5-year survival rate was lower because of late pathologic stage of the tumors in the patients of this series.

Objective To discuss the protection of parathyroid and application of nano-carbon suspen-sion in thyroid surgery .Methods 80 cases were randomly divided into 2 groups:the experimental group which were injected nano-carbon into thyroid during thyroidectomy , and the control group without any injection .Results There were 5 cases with hypocalcemia and 5 cases with PTH decrease in the experimental group , and there were 15 cases and 14 cases respectively in the control group .Pathological results showed that misresection of par-athyroids occurred in 6 cases of the control group(11 parathyroid glands)were while it didn't happen in the experi-mental group .Conclusion Nano-carbon can help to identify and protect the parathyroid , decreasing the proba-bility of parathyroid gland damage during thyroid surgery .

Objective To discuss the role of therapeutic drug monitoring (TDM) in pharmaceutical care by successful intervention of severe drug-drug interaction in 3 patients with hematological disease treated with voriconazole and rifampin.Methods Three patients with hematological disease were monitored for the plasma concentration of voriconazole before,during,and after the concomitant use of rifampin.The severity of this drug interaction was revealed,risks for developing invasive fungal infection and tuberculosis dissemination after chemotherapy were evaluated based on the TDM results,and alternative regimens were recommended.Results Voriconazole plasma concentration was normal at baseline but significantly depressed after combination with rifampin in all 3 cases.Concomnitant use of rifampin leads to a rapid decline in plasma concentration of voriconazole in 2-3 days,and withdraw of this enzyme induction effect takes 8-10 days after discontinuation of rifampin.Conclusion TDM is a helpful tool for providing pharmaceutical care,it helps to objectively visualize the degree of clinically important drug-drug interactions.Clinical evidence together with TDM results suggests high risk for developing invasive fungal infection and tuberculosis dissemination in hematology patients while using this combination therapy.Discontinuation of rifampin was suggested and accepted.For these patients,combination of voriconazole and rifampin should be avoided.

Nowadays, nanotechnologies have shown wide application foreground in the biomedical field of medicine laboratory tests, drug delivery, gene therapy and bioremediation. However, in recent years, nanomaterials have been labeled poisonous, because of the disputes and misunderstandings of mainstream views on their safety. Besides, for the barriers of technical issues in preparation like: (1) low efficacy (poor PK & PD and low drug loading), (2) high cost (irreproducibility and difficulty in scale up), little of that research has been successfully translated into commercial products. Currently, along with the new theory of "physical damage is the origin of nanotoxicity", biodegradability and biocompatibility of nanomaterials are listed as the basic principle of safe application of nanomaterials. Combining scientific design based on molecular level with precision control of process engineering will provide a new strategy to overcome the core technical challenges. New turning point of translational medicine in nanotechnology may emerge.
Biocompatible Materials ; Nanostructures ; toxicity ; Nanotechnology ; Translational Medical Research

OBJECTIVETo find out the regular pattern of pain reaction by pressing along the Governor Vessel at the levels of T3 to L4 on the back in patients with digestive system disease, so as to provide references for diagnosis of the disease.

METHODSThirty patients diagnosed with digestive system disease by gastroscopy and colonoscopy as well as 16 patients with digestive symptoms without accurate diagnosis by endoscopy checks were observed. Pressing was applied from Zhiyang (GV 9) to Yaoyangguan (GV 3), including non-acupoints along the Governor Vessel. Positive reaction was recognized since pain, soreness or distension sensation appeared in the space between the spinous process.

RESULTSThe positive ratios of 30 patients with endoscopy checks and 16 without the check accounted for 100.0%. The tender spots, usually 5 to 9 in number, were mainly focused on the relative acupoints and non-acupoints along the Governor Vessel from T6 to T10.

CONCLUSIONThe pain reaction from Lingtai (GV 10) to Zhongshu (GV 7), which are at the level of T6 to T10, along the Governor Vessel is closely related with digestive system disease. And it can be regarded as function criterion of the digestive system and important reference of auxiliary diagnosis.

Acupuncture Points ; Adult ; Aged ; Back ; physiopathology ; Diagnosis, Differential ; Digestive System Diseases ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Pain ; Pain Measurement ; Sensation

Adolescent ; Adult ; Aged ; China ; DNA Mutational Analysis ; Female ; Genotype ; Hepatitis B ; virology ; Hepatitis B virus ; genetics ; Humans ; Male ; Middle Aged ; Mutation

OBJECTIVE: To review the literature regarding diagnosis and treatment of labral tear. DATA SOURCES: A systematic search was performed in PubMed using various search terms and their combinations including hip, labrum, acetabular labral tear, arthroscopy, diagnosis, and anatomy. STUDY SELECTION: For each included study, information regarding anatomy, function, etiology, diagnosis, and management of acetabular labral tear was extracted. RESULTS: Five hundred and sixty abstracts about anatomy, function, etiology, diagnosis, and management of acetabular labral tear were reviewed and 66 selected for full-text review. The mechanism of labral tear has been well explained while the long-term outcomes of various treatment remains unknown. CONCLUSIONS Labral tear is generally secondary to femoroacetabular impingement, trauma, dysplasia, capsular laxity, and degeneration. Patients with labral tear complain about anterior hip or groin pain most commonly with a most consistent physical examination called positive anterior hip impingement test. Magnetic resonance arthrography is a reliable radiographic examination with arthroscopy being the gold standard. Conservative treatment consists of rest, non-steroidal anti-inflammatory medication, pain medications, modification of activities, physical therapy, and intra-articular injection. When fail to respond to conservative treatment, surgical treatment including labral debridement, labral repair, and labral reconstruction is often indicated.
Acetabulum ; injuries ; Arthroscopy ; Hip Injuries ; Humans ; Rotator Cuff Injuries ; Rupture ; diagnosis

0.05 for all).Conclusions The allelic frequencies of LPL gene at Pvu Ⅱ locus in Hei Yi Zhuang were different from those in Han,but the genotypie frequencies in Hei Yi Zhuang were not different from those in Han.There was no significant correlation between the polymorphism of LPL gene at Pvu Ⅱ site and the serum lipid levels in two ethnic groups.

AIM: To evaluate the anatomic and visual outcomes of 25-gauge vitrectomies combined with air tamponade for the treatment of idiopathic macular hole (IMH).METHODS: Thirty eyes of 27 patients with IMH were included in this prospective interventional study.All patients underwent 25-gauge pars plana vitrectomy (PPV) combined with phacoemulsification and air tamponade.Best corrected visual acuity (BCVA, logMAR), perimetry and multifocal electroretinography (mfERG) were conducted before and after the operation.Anatomical changes were evaluated with optical coherence tomography (OCT).RESULTS: The macular holes closed successfully in 28 eyes after the primary vitrectomy.The mean BCVA improved from 0.72±0.22 logMAR preoperatively to 0.29±0.18 logMAR postoperatively (P<0.001).In the visual field of central 10°, the average mean deviation (MD) decreased from-3.59±1.83 dB preoperatively to-2.51±1.36 dB postoperatively (P<0.001) and the average pattern standard deviation (PSD) decreased from 1.86±0.68 dB preoperatively to 1.33±0.32 dB postoperatively (P=0.001).The retinal response densities of mfERG in the foveal and perifoveal area increased significantly, and implicit times of rings 4-6 prolonged significantly (P<0.05).The symptom duration and baseline N1 amplitude densities at ring 1 had a significant impact on postoperative BCVA (P<0.001, P=0.001, respectively).CONCLUSION: The 25-gauge PPV and air tamponade with 1 day prone positioning produce favorable anatomic and functional outcomes.