OBJECTIVETo study the effect of acupuncture on the immune function of sepsis patients.

METHODSNinety sepsis patients were assigned to the control group, the thymosin a1 group, and the acupuncture treatment group according to random digit table, 30 patients in each group. Patients in the control group were treated according to the guideline of Surviving Sepsis Campaign (SSC). Patients in the control group received routine treatment. Those in the thymosin alpha1 group additionally received subdermal injection of thymosin alpha1 (1.6 mg), once per day for 6 successive days. Needling at related points such as Zusanli (ST36), Yanglingquan (GB34), Neiguan (PC6), Guanyuan (RN4), and so on, was performed in patients of the acupuncture treatment group, once per day for 6 successive days. T cell subgroups (CD3+, CD4+, CD8+, CD4+ /CD8+) and immunoglobulin levels (IgG, IgA, IgM) were detected. The length of ICU hospital stay, hospital readmission rate, and 28-day mortality were compared among the three groups.

RESULTSAfter six days of treatment, CD3+, CD4+, CD8+, IgG, IgA, IgM, and CD4+ /CD8+ ratio of three groups were all significantly increased (P < 0.01). Of them, CD3+, CD4+, CD8+, IgG, IgA, and IgM increased more significantly in the thymosin alpha1 group and the acupuncture treatment group (P < 0.01). Compared with the control group, the ICU hospitalization length was significantly shortened, the hospital readmission rate and the 28-day mortality were lower in the thymosin alpha1 group and the acupuncture treatment group (P < 0.05, P < 0.01). There was no statistical difference in each index between the thymosin alpha1 group and the acupuncture treatment group (P > 0.05).

CONCLUSIONAcupuncture could adjust the immune function of sepsis patients, improve their immunological indicators and prognoses.

Acupuncture Therapy ; CD4-CD8 Ratio ; Humans ; Length of Stay ; Prognosis ; Sepsis ; diagnosis ; immunology ; therapy ; T-Lymphocyte Subsets ; Thymosin ; analogs & derivatives

OBJECTIVEAccidents are an important cause of childhood injury. It is hypothesized that safety education programs can reduce accidents in primary school-aged children. This study aimed to determine whether child and parent safety education programs can decrease the incidence of accidental injury in children when compared with controls.

METHODSThe study population (aged 7-13 years) were recruited from four local primary schools, and randomly assigned into an Intervention or a Control group. The Intervention group received child and parent safety education and was taught injury prevention strategies. The Control group received no injury prevention education or intervention. The incidence of accidental injury was compared between the two groups.

RESULTSIn the first year after intervention the incidence of accidental injury was 262 cases in the Intervention group (8.26%) and 234 cases (8.67%) in the Control group (P > 0.05). In the second year after intervention, however, the incidence of accidental injury was significantly less in the Intervention group (211 cases, 6.54%) compared with the Control group (229 cases, 8.63%) (P < 0.01).

CONCLUSIONSInjury prevention strategies and child and parent safety education can reduce risks of accidental injury in children.

Accident Prevention ; methods ; Adolescent ; Child ; Female ; Humans ; Male ; Parents ; Safety ; Wounds and Injuries ; prevention & control

Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.

Objective To increase the awareness of autoimmune pancreatitis (AIP) and correct diagnosis rate of AIP by investigating radiologic characteristic of AIP and small pancreatic cancers.Methods The clinical data and radiologic imaging of 24 AIP patients who met the Asia diagnostic criteria of AIP in 2008 and 25 cases of pathologically condirmed small pancreatic cancer were retrospectively reviewed.All imaging findings were reviewed,especially on the shape,enhancement patterns of mass,pancreatic ducts,peripancreatic and extra-pancreatic manifestations. Chi-square test and Fisher test were used for statistical analysis.ResultsThe imaging signs,including location of masses,distal pancreatic atrophy,enhancing mass during portal phase,truncated duct sign of pancreatic duct,capsule-like rim and renal involvement,was significantly different between AIP and small pancreatic cancer ( x2 =9.010,10.506,15.488,8.688,6.292 and 4.966 respectively,P ＜0.05 ).But only two signs,distal pancreatic atrophy and enhancing mass during arterial and portal phase,were statistically different between local AIP and small pancreatic cancer (P ＜0.05).ConclusionsThe typical imaging features of diffuse AIP is distinct and helpful for the differential diagnosis of AIP from small pancreatic carcinoma,but there is limited value in the differential diagnosis between local AIP and small pancreatic cancer.

OBJECTIVETo observe the preventive effect of rats' serum containing Buyang Huanwu Decoction (BYHWD) on cultured cardiomyocyte apoptosis of neonatal rat induced by means of 24 hrs hypoxia and 4 hrs reoxygenation, and to investigate its mechanism concerned with nitric oxide (NO).

METHODSMyocyte apoptosis was detected by flow cytometry and ELISA with Annexin V-PI double labeled method. The lactate dehydrogenase (LDH) releasing level was measured with ultraviolet spectrophotometer. The NO concentration was determined by modified Yu method and the concentration of thiobarbituric acid response substance (TBARS) was tested by Ohkawa method.

RESULTSBYHWD contained rats' serum could significantly prevent cardiomyocyte from apoptosis induced by hypoxia and reoxygenation. After hypoxia-reoxygenation, the NO, LDH and TBARS levels in the supernatant of cultured liquid treated with BYHWD were significantly lower than those in non-treated cultured liquid, the effect of BYHWD was dose-dependent.

CONCLUSIONBYHWD can prevent cardiomyocytes from apoptosis induced by hypoxia and reoxygenation, its mechanism might be related with oxygen free radical and NO scavenging produced during the hypoxia-reoxygenation process.

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cell Hypoxia ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Myocytes, Cardiac ; cytology ; drug effects ; Nitric Oxide ; metabolism ; Oxygen ; pharmacology ; Phytotherapy ; Rats ; Rats, Wistar

OBJECTIVETo evaluate the short-term clinical and radiographic results of modular fully porous-coated stem in revision operation of total hip arthroplasty.

METHODSFrom May 2001 to November 2002, ten cases with twelve hips received revision total hip arthroplasty using modular Profemur R with fully porous-coated stem. There were three males and seven females and the average age was 54.2 years (35 to approximately 71 years). The reasons for revision operation included aseptic loosing in eleven hips and septic loosing in one hip. All the patients were evaluated radiographically and clinically. Radiographic evaluation included the classification of bone loss, leg discrepancy, offset and antiversion before and after revision and bone in-growth postoperatively. Clinical evaluation were based on Harris score system.

RESULTSThe average follow-up period is 13.5 months (range: 6 to approximately 24 months). Leg discrepancy from more than 2 cm in six cases were restored to less than 1 cm postoperatively. Femoral offset, antiversion angle and neck-shaft angle were also restored to normal limitation. All the patients were allowed to full weight-bearing 3 to approximately 5 months later and pain relief occurred in all involved hips. At the last follow-up, bone in-growth occurred in eleven hips and solid fibrous fixation only in one case. Harris score was improved from a mean of 25 to 72. Complications mainly consisted of femoral shaft fracture in three cases but no infection or dislocation was found postoperatively.

CONCLUSIONSSatisfactory results of short-term radiographic and clinical follow-up can be achieved using modular fully porous-coated stem for revision total hip arthroplasty.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Bone Cements ; Cementation ; Coated Materials, Biocompatible ; therapeutic use ; Female ; Follow-Up Studies ; Hip Joint ; diagnostic imaging ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Radiography ; Reoperation

OBJECTIVETo investigate the gene expression and potential functions of transforming growth factor-beta1 in osteophyte development.

METHODSA total of 25 specimens were obtained from individuals undergoing total knee arthroplasty due to severe primary osteoarthritis. Tissue samples were embedded in paraffin wax and made into sections. Hematoxylin and eosin and toluidine blue stainings were performed. The expressions of collagen I, IIa, IIb, and X were detected by immunohistochemistry. Based on the histomorphology of cellularity and matrix abundance, the glycosaminoglycans content, and the differential expressions of collagen I, IIa, IIb, and X, the osteophytic tissues were classified. For each different type of osteophyte, expressions of transforming growth factor-beta1 were detected by immunohistochemistry and in situ hybridization, and results were analyzed using the image analysis system.

RESULTSFive different types of osteophytes were identified as type I, type II, type III, type IV, and type V. Transforming growth factor-beta1 mRNA was more and intensely expressed in chondrocytes of type II and III osteophytes, and was less in other types of osteophytes. The difference was significant (P<0.05, P<0.01).

CONCLUSIONTransforming growth factor-beta1 mRNA is mainly expressed in early-mid stages of osteophytes and may play an important role in promoting the proliferation and differentiation of chondrocytes in the early stages of osteophyte development.

Chondrocytes ; metabolism ; pathology ; Humans ; Osteoarthritis, Knee ; metabolism ; pathology ; Osteophyte ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; Transforming Growth Factor beta1 ; biosynthesis ; genetics

OBJECTIVETo investigate the prosthesis selection, precaution and curative effect of total knee replacement in severe gonarthrosis.

METHODSFrom January 1996 to July 2009, 50 patients (58 knees) with severe gonarthrosis underwent total knee replacement, included 12 males and 38 females, aged from 46 to 80 years with an average age of 66.5 years old. Six artificial hinged knee joints, 37 general knee joints and 15 ScorpioNRG knee joints were used according to the deformity of the knees. Fifty patients (58 knees) were followed up and evaluated with the HSS (the Hospital for Special Surgery Knee Score) scoring system.

RESULTSThe duration of follow-up ranged from 6 months to 8 years (means 62 months). According to the HSS scoring system, the mean preoperative score was (38.6 +/- 8.76) points, and the postoperative score was (86.50 +/- 9.45) points. The clinical effect was excellent in 20 cases (23 knees), good in 28 cases (32 knees),and acceptable in 2 cases (3 knees).

CONCLUSIONStable and functional recovery knee joint without deformities and pains could be obtained after total knee replacement by carefully chosing of prosthetic replacements according to the different degrees of joint deformity of severe gonarthrosis.

Aged ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Joint Deformities, Acquired ; surgery ; Knee Joint ; pathology ; Male ; Middle Aged ; Osteoarthritis, Knee ; pathology ; surgery

OBJECTIVETo investigate the methods of restoring normal level of rotation center of the hip and limb length in patients with osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) using total hip arthroplasty (THA).

METHODSFrom January 2000 to January 2003, total hip arthroplasties were performed for 21 patients (26 hips) with OA secondary to DDH. There were 19 females and 2 males with an average age of 51 years (range from 40 to 66 years). Based on radiographic classification of Crowe, there were 12 in type I, 5 in type II, 2 in type III and IV respectively. In addition to the standard procedure of THA, the methods of restoring normal level of rotating center of the hip included structural bone autografting and medialization of the cup. The methods of limb length restoration included carefully preoperative planning and intraoperative soft tissue release. During the follow-up period at 3, 6, 12 months postoperatively and then annually thereafter, rotation center of the hip and limb length were assessed radiographically. Harris score system (HSS) was used for clinical evaluation.

RESULTSAll the patients were followed up for a mean time of 26.4 months (range from 12 to 48 months). All the patients had restoration of the normal level of rotation center of the hip. At the latest follow-up, Harris score was improved from preoperative 35 points (range from 12 to 68 points) to postoperative 94 points (range from 74 to 100 points).

CONCLUSIONIn addition to standard procedure, the restoration of normal level of rotation center of the hip could be achieved by structural bone autografting and medialization of the cup in THA for patients with DDH. Careful preoperative planning and intraoperative soft tissue release could restore limb length.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Follow-Up Studies ; Hip Dislocation, Congenital ; complications ; surgery ; Humans ; Male ; Middle Aged ; Osteoarthritis, Hip ; etiology ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the value of (18)F-FDG and (11)C-MET PET-CT scan in differentiation of brain ringlike-enhanced lesions on MRI imaging.

METHODSForty-one brain ringlike-enhanced lesions on MRI imaging including 30 brain tumors and 11 non-neoplastic lesions confirmed pathologically or clinically underwent (18)F-FDG and (11)C-MET PET-CT brain scan. Among them, 15 patients who were suspected to have brain metastasis received body scan by (18)F-FDG PET-CT. Both images were analyzed visually and semi-quantitatively.

RESULTSVisual analysis: for brain tumors the diagnostic sensitivity, specificity and accuracy of (18)F-FDG PET-CT was 53.3%, 72.7%, 58.5%, versus 96.7%, 90.9%, 95.1% of (11)C-MET PET-CT, respectively. All the primary foci in 9 patients with brain metastases were detected by body (18)F-FDG PET-CT scan. Semiquantitative analysis: There was a significant difference in the uptake between highly differentiated malignant and poorly differentiated tumors as well as non-neoplastic lesions for both tracers (P < 0.01), while between low-grade malignant tumors and non-neoplasm lesions, there was a difference in uptake only by (11)C-MET (P < 0.01). No significant difference between the uptakes in brain metastasis and glioblastomas was found by both tracers (P > 0.05).

CONCLUSIONBoth (18)F-FDG and (11)C-MET PET-CT are useful in differentiation of brain ringlike-enhanced lesions on MRI imaging. (11)C-MET PET-CT is more helpful than (18)F-FDG PET-CT in differential diagnosis of low-grade neoplastic from non-neoplastic lesions. Combination of (18)F-FDG and (11)C-MET PET-CT scans can improve the accuracy of differential diagnosis for brain ringlike-enhanced lesions on MRI imaging.

Acetates ; Adolescent ; Adult ; Aged ; Brain Abscess ; diagnosis ; Brain Neoplasms ; diagnosis ; pathology ; secondary ; Carbon ; Carbon Radioisotopes ; Child ; Craniopharyngioma ; diagnosis ; pathology ; secondary ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Glioblastoma ; diagnosis ; pathology ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Neoplasms ; diagnosis ; pathology ; secondary ; Positron-Emission Tomography ; methods ; Radiopharmaceuticals ; Sensitivity and Specificity ; Young Adult