Acupuncture Therapy ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; therapy

Objective To investigate the outcome of the urethral realignment simultaneous internal fixation in treatment of pelvic fracture associated with posterior urethral disruption. Methods The study included 33 patients with pelvic fracture associated with posterior urethral disruption treated simultaneously by urethral realignment and internal fixation from December 2003 to August 2009. According to AO classification, two patients were with type A2 fracture, six with type B1 ,seven with type B2,five with type B3 ,six with type C1 ,four with type C2 and three with type C3. All the patients were found with complete posterior urethral disruption. Primary urethral realignment combined with emergency open reduction and internal fixation of pelvic fracture were performed in 12 patients. Due to unstable condition, 21 patients underwent primary suprapubic cystostomy and external fixation, sequentially delayed urethral realignment and internal fixation.Results The mean follow-up time of all patients was 37 months ( range, 3-63 months). Of all the patients, 25 patients (76%) regained good without urethral dialation or needed only short term urethral dilatation, and eight patients (24%) suffered from urethral stricture and needed further complex surgery. The incidences of urinary incontinence and erectile dysfunction were 6%(2/33) and 18% (6/33). The erectile dysfunction of two patients was ascribed to sacral nerve injury.At the final follow-up, the mean score was 90.3 points (range, 66-100) according to the Majeed' s scoring system, which showed that the result was excellent in 24 patients, good in eight and fair in one.Conclusions Urethral realignment and simultaneous internal fixation can attain good clinical results for pelvic fracture associated with posterior urethral disruption. It takes advantages of minor surgical trauma,short treatment cycle, good outcome and low complication rate.

Adult ; Butadienes ; adverse effects ; Chemical Industry ; Environmental Monitoring ; Humans ; Middle Aged ; Occupational Exposure ; adverse effects ; Occupational Health ; Physical Examination ; Young Adult

Objective To observe the effect of long-term intensive glucose control therapy on diabetic retinopathy in outpatients with type 2 diabetes mellitus.Methods Forty-nine patients with type 2 diabetes mellitus were randomly assigned to participate in the trial from 2002 to 2007,receiving either intensive (24 cases) or standard glucose control (25 cases).The patients were examined by the same ophthalmologists to identify any new diabetic retinopathy (DR).After 5 years of intensive glucose control,all of the patients were asked to attend our clinic every 6 months,but no attempts were made to maintain their previously assigned therapies.Hemoglobin A1c (HbA1 c) was measured regularly.In November of 2009,a retinal examination was carried out by the same ophthalmologist who worked in the trial.The visual acuity,lens,vitreous body and fundus were examined after pupil dilation to identify diabetic retinopathy (DR).Fundus fluorescein angiography and retinal laser photocoagulation were carried out when necessary.Results In the second year after enrollment in the trail,the median HbA1c level of the intensive-therapy group was significantly lower than that of the standard-therapy group [(6.3 ± 0.6) ％ vs.(7.2 ± 1.2) ％,t =2.09,P ＜ 0.05],and was maintained in a controlled level throughout the following 4 years.During the post-trial monitoring,no new case of of macula edema or diabetic associated blindness occurred in either intensive or standard-therapy group,the whole occurrence of micro-aneurysms,fundus hemorrhage,as well as those who needed retinal laser photocoagnlation and lowering in visual acuity in intensive-therapy group was lower than that in the standard-therapy group (3 vs.14,1 vs.7,2 vs.4,3 vs.11,respectively ;9 vs.36,totally,x2 =4.719,P ＜ 0.05).During the first post-trial monitoring,there was no difference in median HbAlc level between intensive-therapy group and standard-therapy group [(7.2 ± 1.1) ％ vs.(7.3 ± 1.3) ％,t =0.25,P =0.806],which was sustained in the following years.In the trail,no new case of fundus hemorrhage or diabetic associated blindness occurred in intensive-therapy group during the five-year period of therapy.Number of new episodes of micro-aneurysm,macula edema were less in intensive-therapy group than that in standard-therapy group,number of new episodes of lowering in visual acuity,and those who needed retinal laser photocoagnlation,were significantly less in intensive-therapy group than that in standardtherapy group(15 vs.25,4 vs.23,Z =-4.459,P ＜ 0.05) during five-year follow-up.Conclusions The benefit of reduced incidence of diabetic retinopathy in intensive glucose can be maintained because of the legacy effect.

Acupuncture Therapy ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; injuries

Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) derived cardiac function index (Tei index) in patients with acute coronary syndrome under different plasma glucose levels and to evaluate the influence of hyperglycemia on the preciseness of cardiac function assessment with NT-proBNP.Methods Consecutive patients with acute coronary syndrome admitted to the department of cardiology in Guangdong General Hospital were prospectively enrolled.Based on their plasma fasting glucose level,patients were divided into hyperglycemia group (fasting plasma glucose ≥ 6.1 mmol/L) and euglycemia group (fasting plasma glucose ＜ 6.1 mmol/L).All the patients underwent transthoracic echocardiagraphy and tissue Doppler imaging (TDI) investigations.Blood samples were obtained within 24 hours of hospitalization for measurment of NT-proBNP level.Relationship between TDI-Tei index and the level of NT-proBNP in the two groups were analyzed respectively.Results The TDI-Tei index,the systolic index and the diastolic index were all significant higher in the hyperglycemia group (n =27) than those in the euglycemia group (n =35)(0.68±0.14) vs.(0.61 ±0.10),P =0.03; (0.29±0.07) vs.(0.26±0.05),P =0.045; (0.38±0.08) vs.(0.35 ±0.050,P =0.03,respectively.In both groups,TDI-Tei and In NT-proBNP showed significant linear regression.In the hyperglycemia group,TDI-Tei =0.175 + 0.068 In NT-proBNP,R2 =0.702,P ＜ 0.01.In the euglycemia group,TDI-Tei =0.185 + 0.060 In NT-proBNP,R2 =0.405,P ＜ 0.01.Conclusions (1) Compared with patients suffering from an acute coronary syndrome with euglycemia,the global cardiac function of patients with hyperglycemia is poorer; (2) NT-proBNP correlates significantly with TDI-Tei in both hyperglycemia and euglycemia patients with acute heart syndrome.It is appropriate to assess global cardiac function with NT-proBNP in patients suffering from ACS complicated with hyperglycemia.

Objective To detect the expressions of nm23-H1 and heat shock protein 27 (HSP27) and their clinical significance on development and metastasis in non-small cell lung carcinoma (NSCLC).Methods 75 tumor tissues from patients with NSCLC were included as experimental group and 28 pulmonary benign lesion tissues were as control group.The expressions of nm23-H1 and HSP27 in patients with different clinical and pathological characters were detected by immunohistochemistry.Results nm23-H1 and HSP27 were mainly expressed in cytoplasm,the positive rates of nm23-H1 and HSP27 were significantly higher in the experimental group than that in control group [41.3 ％ (31/75) vs 7.1％ (2/28),x2 =10.946,P =0.001,80.0 ％ (60/75) vs 46.4 ％ (13/28),x2 =11.131,P =0.001].Compared with control group,the positive rate of HSP27 was correlated with the degree of tumor differentiation (x2 =4.191,P =0.041).nm23-H1 was related with HSP27 in lung cancer (r =0.284,P =0.013).Conclusion nm23-H1 and HSP27 are related to the occurrence and development of NSCLC.The joint detection of nm23-H1 and HSP27 should be helpful to the diagnosis and judge the biological behavior of NSCLC.

OBJECTIVETo investigate the safety, medium-term and long-term efficacy of transradial percutaneous coronary intervention for unprotected left main coronary artery lesions with 6 French guiding catheter.

METHODSSixty-one patients with unprotected left main coronary artery lesions were treated by 6 French transradial percutaneous coronary intervention between January 2008 and December 2009. The mean age of patients was (66.03 ±10.02)years (44-87). Among 61 cases, 40 had hypertension and 14 had diabetes mellitus; 22 had a history of smoking. The average left ventricle ejection fraction was (62.96 ±12.15)% (range: 28-86) and the average plasma creatinine level was (82.92 ±18.30)μmol/L (range: 44-130). The major adverse cardiac events (MACE) after the procedure were evaluated.

RESULTSProcedural success was achieved in all cases. A total of 67 stents were implanted. No in-hospital death occurred. Mean clinical follow-up period was (26.25 ±5.92) months (range: 19-44 months). MACE developed in 6 cases (9.8%) during the follow-up period, including 2 death (3.3%) and 4 case of target lesion revascularization (6.6%). Compared with low-risk group (SYNTAX score<33), MACE was increased in the high-risk group (SYNTAX score>32).

CONCLUSION6 French transradial percutaneous coronary intervention for patients with unprotected left main coronary artery lesions is safe and feasible procedure with desirable medium-and long-term outcomes.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; methods ; Radial Artery ; Treatment Outcome

OBJECTIVETo study the role of mast cells in the differential diagnosis of cellular leiomyoma and endometrial stromal sarcoma of uterus and its mechanism.

METHODSUsing SP immunohistochemical technique, the expression of proliferating cell nuclear antigen (PCNA) and mast cells in 25 cellular leiomyoma (CL) and 26 endometrial stromal sarcoma (ESS) of uterus were examined. The expression of estrogen receptor (ER) and CD44v3 in cellular leiomyoma was also studied.

RESULTSThe expression of PCNA was not significantly different from CL or ESS (P > 0.05), while mast cell count was statistically different between them (P < 0.01). Using a value of less than 7 mast cells per high power field was useful for the diagnosis of ESS, yielding 100% sensitivity and 92.0% specificity. There was a positive correlation between the mast cell count and CD44v3 in CL (r(s) = 0.589, P < 0.01), though no correlation was observed between mast cell count and PCNA or ER.

CONCLUSIONNumber of mast cells is valuable for the discrimination of CL from ESS in the uterus. The mechanism and the role of higher quantity of mast cells in CL need further study.

Adult ; Aged ; Female ; Humans ; Hyaluronan Receptors ; analysis ; Leiomyoma ; chemistry ; pathology ; Mast Cells ; pathology ; Middle Aged ; Proliferating Cell Nuclear Antigen ; analysis ; Receptors, Estrogen ; analysis ; Sarcoma, Endometrial Stromal ; chemistry ; pathology ; Uterine Neoplasms ; chemistry ; pathology

Objective To investigate plasma levels of total carnitine (TC) and free camitine (FC) in patients undergoing hemodialysis and peritoneal dialysis.Methods 200 cases of normal group came from physical examination in this hospital,all testing cases were the in-hospital patients in the department of nephropathy.TC and FC were determined by use of an enzymatic cycle assay on Hitachi 7170 automatic biochemical analyzer.Results In 200 cases of normal group,TC level was (56.52?9.61) ?mol/L,and FC was (46.60?8.23) ?mol/L.In 37 hemodialysis patients,TC and FC levels were (41.47?13.22) ?mol/L and (24.58?8.91)?mol/L before dialysis,a statistic difference was observed against the control group (P0.05).Conclusions Carnitine deficiency was seen in most patients undergoing hemodialysis and peritoneal dialysis.Furthermore,the deficiency status got worse along with the dialysis course in hemodialysis patients.Carnitine infusion can effectively improve the status of these patients.