ObjectiveTo evaluate the efficacy of different dones of urapidil in preventing pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy.MethodsSixty ASA Ⅰ or Ⅱ patients,aged 27-41 yr,weighing 55-65 kg,scheduled for elective laparoscopic myomectomy under general anesthesia,were randonly divided into 4 groups (n =15 each):control group (group C) and urapidil 0.3,0.5 and 0.8 mg/kg groups (groups U1-3).Urapidil 0.3,0.5 and 0.8 mg/kg were injected intravenously in U1-3 groups respectively,while normal saline 5 ml was given in group C.The mixture of pituitrin 6 U and normal saline 20 ml was injected into the site of hysteromyoma 5 min later.The operation was then started.BIS value was maintained at 45-55.The occurrence of cardiovascular responses was recorded.ResultsThe incidences of cardiovascular responses were 100％,67％,40％ and 20％ in groups C and U1-3 respectively.The incidence of cardiovascular responses was significantly lower in groups U1-3 than in group C,and in groups U2.3 than in group U1 ( P ＜ 0.01 ).There was no significant difference in the incidence of cordiovascular responses between U2 and U3 groups (P ＞ 0.05).ConclusionUrapidil can prevent pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy and the optimal dose is 0.5 mg/kg.

OBJECTIVETo introduce the experience in the treatment of lower eyelid pouches orbital rim.

METHODSAn incision was made along the margin of lower eyelid and dissection was performed under the orbicularis muscle to expose the orbital septum and periosteum of lower orbital rim. The fat released from orbital septum was transposed just below the lower orbital rim and fixed on the periosteum. If lacrimal groove deformity was not corrected completely, the musculocutaneous flap, which may be excised beside the incision, was kept to correct the deformities further with only the muscle portion.

RESULTS72 cases with lower eyelid pouches complicated with lacrimal groove deformities were treated with transposition of orbital fat and orbicularis muscular flaps. Satisfactory results were achieved in all the patients after a follow-up period of 3-6 months.

CONCLUSIONIt is an effective and feasible technique to correct lacrimal groove deformities with transposition of orbital fat and orbicularis muscular flaps.

Adipose Tissue ; transplantation ; Aged ; Blepharoplasty ; methods ; Eyelids ; surgery ; Humans ; Orbit ; Periosteum ; surgery

Decoction is one of the most commonly used dosage forms of traditional Chinese medicine. The stability of chemical constituents in decoction is closely related to the clinical efficacy and safety. There were few reports about the influence of metal ions in the stability of chemical constituents in traditional Chinese medicine. However, there is no evidence that metal ions in decoction water need to be controlled. In this study, 2,3,5,4'-tetrahydroxy stilbene-2-O-β-D-glucoside (THSG), one of the main constituents in Polygoni Multiflori Radix was studied. Ordinary tap water, deionized water, and water containing different metal ions were used to investigate and compare the influence on THSG. The results showed that after storage in a dark place at the room temperature for 10 days, the degradation of THSG was 7% in deionized water, while undetectable in tap water. The content of THSG could be decreased by different kinds of metal ions, and the effect was concentration-dependent. Moreover, Fe3+ and Fe2+ showed the greatest influence at the same concentration; and our study has shown that THSG decreased more than 98% in Fe and Fe2+ solutions at 500 ppm concentration. In the same time we found out p-hydroxybenzaldehyde (molecular weight: 122.036 7) and 2,3,5-trihydroxybenzaldehyde-2-O-glycoside (molecular weight: 316.079 4) were the main degradation products of THSG in tap water and water containing Cu2+, Ca2+, Zn2+, Mg2+ and Al3+. The product of THSG dimer with a water molecule was found in water containing Fe3+ and Fe2+. The above results showed that the metal ions in water could significantly influence the stability of THSG in water, indicating that the clinical efficacy and safety of decoction would be affected if the metal ions in water were not under control. It's suggested that deionized water should be used in the preparation of decoction containing Polygoni Multiflori Radix in the clinic to avoid degradation of THSG. Meanwhile, decoction prepared by tap water should be taken by patients in a short time. Our investigation provides important information and reference about the influence of metal ions on the stability of decoctions in other traditional Chinese medicine that have unstable groups such as hydroxyls and unsaturated bonds, etc.
Drugs, Chinese Herbal ; chemistry ; Glucosides ; chemistry ; Ions ; chemistry ; Metals ; chemistry ; Plant Roots ; chemistry ; Polygonaceae ; chemistry ; Stilbenes ; chemistry

OBJECTIVETo investigate the clinical results of the treatment of severe infantile hemangioma with high-dose propranolol in Chinese.

METHODS56 cases with severe infantile hemangioma were treated with propranolol. Clinical evaluation, electrocardiography, and experimental examination of liver function and heart function were performed before treatment. The daily dose of propranolol was increased from 1 mg/kg at the first day to 1.5 mg/kg at the second day, and to 2 mg/kg at the third day. The propranolol was given twice a day. The treatment was lasted for six months. The patients were visited every month.

RESULTSThe lesion color was changed after 2-4 days of treatment in all the cases. All the lesions were dramatically improved after one month of treatment. The ulceration were healed, except one case. Until now, complete regression was achieved in 10 cases and marked improvement in 46 cases. Side effects were happened in 3 cases, including one case of abnormal liver function, one case of CK-MB increase and one case of continuous increase of CK-MB, LDH, ALT, GGT.

CONCLUSIONSHigh-dose Propranolol is very effective in the treatment of infantile hemangioma with minor side effects and short disease period. It might he used as the first-line treatment for infantile hemangioma.

China ; Female ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Propranolol ; administration & dosage ; therapeutic use ; Treatment Outcome

The purpose of study was to investigate the feasibility for establishing erythroleukemia model in CB6F1 mice by transplant with haploidentical mouse leukemic cell line FBL-3 and to explore the biological characteristics of FBL-3 cells in CB6F1 mice, CB6F1 and C57BL/6 mice were inoculated intravenously at doses of 1×10(3)-1×10(7) FBL-3 cells respectively. The survival time, the count of peripheral white blood cells, the percentage of erythroblasts and chromosome of these mice were observed. The liver, spleen, lung and kidney were obtained from the dying CB6F1 mice for pathological examination. The ultrastructure of erythroblasts in bone marrow and spleen was observed by transmission electron microscopy as soon as these mice died. Expression of MHC molecules and karyotype of spleen and bone marrow cell were measured. The results showed that 100% and 92.5% incidences of erythroleukemia were observed when 1×10(3)-1×10(7) FBL-3 cells had been administrated intravenously to CB6F1 and C57BL/6 mouse, respectively. There was a linear relationship between the survival time and the number of inoculated leukemic cells. The survival time of CB6F1 was longer than C57BL/6 mice inoculated the same number cell. The main targets for FBL-3 cell infiltration were liver, spleen, marrow, lung and kidney. The reaction of FBL-3 cells to glycogen staining was positive, while the to reaction peroxidase, alkaline phosphatase and butyric acid staining were negative, reaction to chloroacetic acid staining partially was positive. Virus-like particles were found in the spleen and bone marrow cells under electron microscope. Chromosomes of spleen and bone marrow cells in the majority were non-diploid, and the expression of H-2b increased, H-2d expression decreased. It is concluded that the erythroleukemia mouse model can be established in CB6F1 mice transplanted with leukemic FBL-3 cells, that provides a convenience experimental erythroleukemia model for study.
Animals ; Cell Line, Tumor ; Disease Models, Animal ; Female ; Leukemia, Erythroblastic, Acute ; Male ; Mice ; Mice, Inbred C57BL ; Neoplasm Transplantation

OBJECTIVETo study the expression changes of matrix metalloproteinases (MMPs) in traumatic deep vein thrombosis (TDVT) in a rat model with the aid of gene chip technology and to explore the roles of MMPs in TDVT.

METHODSTotally 150 Sprague Dawley rats were randomly divided into control group (n equal to 10) and model group (n equal to 140). Rat models of TDVT were established by clamping the femoral vein and fixing the bilateral hind limbs. Then fixation of the hip spica with plaster bandage was conducted. According to the observation phases and/or biological situations of the femoral vein thrombosis, the model rats were further divided into 7 groups. Vascular tissues were obtained from each group through noninvasive incision into the femoral vein at corresponding time points. We adopted the Trizol one-step method for total RNA extraction, Affymetrix RAT 230 2.0 array for detection of RNA expressions and fold change (FC) analysis for changes of differential expressions of MMPs in each group. The main outcome parameters measured included expressions of MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, MMP-11, MMP-12, MMP-13, MMP-14, MMP-16, MMP-23 and MMP-24. Gene array data of these MMPs were analyzed by the Affymetrix Microarray Analysis software (Version 5.0).

RESULTSFC analysis showed differential expressions of MMPs in each group during the course of TDVT. At the initial period of thrombosis, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, MMP-11, and MMP-24 had significantly high expression, while MMP-12, MMP-13, MMP-14, MMP-16 and MMP-23 had relatively low expression. MMPs were all highly expressed at the peak time of thrombosis. In the process of thrombus resolution, MMP-2, MMP-10, MMP-16 and MMP-24 have relatively low expression, while MMP-12, MMP-13, MMP-14, MMP-16 and MMP-23 have significantly high expression.

CONCLUSIONMMPs may affect the process of TDVT through transcription regulation of the fibrinolysis-anti-fibrinolytic system during the course of thrombosis and thrombus resolution.

Animals ; Disease Models, Animal ; Matrix Metalloproteinases ; physiology ; Rats ; Rats, Sprague-Dawley ; Venous Thrombosis ; enzymology ; etiology ; Wounds and Injuries ; complications

OBJECTIVETo probe into the mechanism of electroacupuncture intervention for lipid metabolism of metabolic syndrome patients.

METHODSEighty cases of metabolic syndrome were randomly divided into an electroacupuncture combined with western medicine group (observation group) and a simple western medicine group (control group), 40 cases in each group. The observation group was treated with electroacupuncture at Back shu points, Zusanli (ST 36),Zhongwan (CV 12),Sanyinjiao (SP 6) etc. as main combined with oral administration of Simvastatin, Glipizide XL, and Felodipine sustained-release tablets for lipid-lowering, glucose-lowering and antihypertensive treatment; the control group was treated with oral administration of western medicine only (the medicine was the same with observation group). The Body Mass Index (BMI) and the blood lipid of the patients were detected respectively before and after treatment.

RESULTSThe BMI, Three Acids Glyceride (TG), Total Cholesterol(TC), Low Density Lipoprotein Cholesterol (LDL-C) and High Density Lipoprotein Cholesterol (HDL-C) were compared respectively before and after treatment, there were significant differences between them in observation group (all P < 0.01); while in control group, there were significant differences of TG,TC,LDL-C and HDL-C before and after treatment (all P < 0.01), and with no significant difference in BMI before and after treatment. There were significant differences of BMI,TG,TC,LDL-C and HDL-C between two groups after treatment (P < 0.01, P < 0.05).

CONCLUSIONThe electroacupuncture has an obvious effect to reduce body mass, and acupuncture combined with medication has a better effect of improving the lipid metabolism than simple medication.

Acupuncture Points ; Adult ; Body Mass Index ; Electroacupuncture ; Female ; Humans ; Hypolipidemic Agents ; administration & dosage ; Lipid Metabolism ; Lipids ; blood ; Male ; Metabolic Syndrome ; drug therapy ; metabolism ; therapy ; Middle Aged

In this study, the inhibitory effect of human umbilical cord-derived mesenchymal stem cells (hUCMSC) on interleukin-17 (IL-17) production in peripheral blood T cells from patients with spondyloarthritis (SpA) were investigated, in order to explore the therapeutic potential of hUCMSC in the SpA. Peripheral blood mononuclear cells (PBMNC) were isolated from patients with SpA (n = 12) and healthy subjects (n = 6). PBMNC were cultured in vitro with hUCMSC or alone. The expression of IL-17 in CD4(+) T cells or γ/δ T cells were determined in each subject group by flow cytometry. IL-17 concentrations in PBMNC culture supernatants were measured by ELISA. The results indicated that the proportion of IL-17-producing CD4(+) T cells and IL-17-producing γ/δ T cells of SpA patients were 4.5 folds and 5 folds of healthy controls [CD3(+)CD4(+)IL-17(+) cells (3.42 ± 0.82)% vs (0.75 ± 0.25)%, P < 0.01; CD3(+)γδTCR(+)IL-17(+) cells (0.30 ± 0.10)% vs (0.06 ± 0.02)%, P < 0.01]. After co-culture of PBMNC in patients with hUCMSC, the increased proportions of CD3(+)CD4(+)IL-17(+) cells and CD3(+)γδTCR(+)IL-17(+) cells in SpA patients were inhibited significantly by hUCMSC [CD3(+)CD4(+)IL-17(+) cells (3.42 ± 0.82)% vs (1.81 ± 0.59)% (P < 0.01); CD3(+)γδTCR(+)IL-17(+) cells (0.30 ± 0.10)% vs (0.16 ± 0.06)% (P < 0.01]. In response to phytohemagglutinin (PHA, 1 µg/ml), PBMNC from SpA patients secreted more IL-17 than that from healthy control [(573.95 ± 171.68) pg/ml vs (115.53 ± 40.41) pg/ml (P < 0.01)]. In the presence of hUCMSC, PBMNC of SpA patients produced less amount of IL-17 [(573.95 ± 171.68) pg/ml vs (443.20 ± 147.94) pg/ml, (P < 0.01)]. It is concluded that the IL-17 production in peripheral blood T cells from SpA patients can be inhibited by hUCMSC, which have therapeutic potential for SpA.
Humans ; Interleukin-17 ; metabolism ; Leukocytes, Mononuclear ; cytology ; Lymphocyte Count ; Mesenchymal Stromal Cells ; Spondylarthritis ; blood ; metabolism ; therapy ; T-Lymphocytes ; metabolism ; Umbilical Cord ; cytology

Objective:To investigate the efficacy of the classified reduction based on CT two-dimensional images for the surgical treatment of single segment facet joint dislocation in subaxial cervical spine.Methods:A retrospective case series study was made on 105 patients with single segment facet joint dislocation in subaxial cervical spine admitted to Zhengzhou Orthopedic Hospital from January 2015 to October 2022. There were 63 males and 42 females, with the age range of 22-78 years [(47.5±3.6)years]. Preoperative American Spinal Cord Injury Association (ASIA) classification was grade A in 23 patients, grade B in 45, grade C in 22, grade D in 15 and grade E in 0. The classification of surgical approach was based on the presence or not of continuity between anterior and posterior subaxial cervical structures and the movability of the posterior cervical facet joint on CT two-dimensional images, including anterior cervical surgery if both were presented and posterior facet joint resection plus anterior cervical surgery if there was discontinuity between anterior and posterior subaxial cervical structures or posterior facet joint fusion. Reduction procedures were applied in accordance with the type of facet joint dislocation classified based on the position of the lower upper corner of facet joint, including skull traction or manipulative reduction for the dislocation locating at the dorsal side (type A), intraoperative skull traction and leverage technique for the dislocation locating at the top (type B) and intraoperative skull traction and leverage technique with boosting for the dislocation locating at the ventral side (type C). If the dislocation of two facet joints in the same patient was different, the priority of management followed the order of type C, type B and type A. The reduction success rate, operation time and intraoperative blood loss were recorded. The cervical physiological curvature was evaluated by comparing the intervertebral space height and Cobb angle before operation, at 3 months after operation and at the last follow-up. The fusion rate of intervertebral bone grafting was evaluated by Lenke grading at 3 months after operation. The spinal cord nerve injury was assessed with ASIA classification before operation and at 3 months after operation. Japanese Orthopedic Association (JOA) score was applied to measure the degree of cervical spinal cord dysfunction before operation and at 3 months after operation, and the final follow-up score was used to calculate the rate of spinal cord functional recovery. The occurrence of complications was observed.Results:All patients were followed up for 3-9 months [(6.0±2.5)months]. The reduction success rate was 100%. The operation time was 40-95 minutes [(58.6±9.3)minutes]. The intraoperative blood loss was 40 to 120 ml [(55.7±6.8)ml]. The intervertebral space height was (4.7±0.3)mm and (4.7±0.2)mm at 3 months after operation and at the last follow-up, significantly decreased from preoperative (3.1±0.5)mm (all P<0.01), but there was no significant difference in intervertebral space height at 3 months after operation and at the last follow-up ( P>0.05). The Cobb angle was (6.5±1.3)° and (6.3±1.2)° at 3 months after operation and at the last follow-up, significantly increased from preoperative (-5.4±2.2)° (all P<0.01), but there was no significant difference in Cobb angle at 3 months after operation and at the last follow-up ( P>0.05). The fusion rate of intervertebral bone grafting evaluated by Lenke grading was 100% at 3 months after operation. The ASIA grading was grade A in 15 patients, grade B in 42, grade C in 29, grade D in 12 and grade E in 7 at 3 months after operation. The patients showed varying degrees of improvement in postoperative ASIA grade except that 15 patients with preoperative ASIA grade A had partial recovery of limb sensation but no improvement in ASIA grade. The JOA score was (13.3±0.6)points and (13.1±0.6)points at 3 months after operation and at the last follow-up, significantly improved from preoperative (6.8±1.4)points (all P<0.01), but there was no significant difference in JOA score at 3 months after operation and at the last follow-up ( P>0.05). The rate of spinal cord functional recovery was (66.3±2.5)% at the last follow-up. All patients had no complications such as increased nerve damage or vascular damage. Conclusion:The classified reduction based on CT two-dimensional images for the surgical treatment of single segment facet joint dislocation in subaxial cervical spine has advantages of reduced facet joint dislocation, recovered intervertebral space height and physiological curvature, good intervertebral fusion and improved spinal cord function.

BACKGROUNDEnd-stage hypertrophic cardiomyopathy (HCM) is complicated by substantial adverse events. However, few studies have focused on electrocardiographic features and their prognostic values in HCM. This study aimed to evaluate the clinical manifestations and prognostic value of electrocardiography in patients with end-stage HCM.

METHODSEnd-stage HCM patients were enrolled from a total of 1844 consecutive HCM patients from April 2002 to November 2013 at Fuwai Hospital. Clinical data, including medical history, electrocardiography, and echocardiography, were analyzed. Cox hazards regression analysis was used to assess the risk factors for cardiovascular mortality.

RESULTSEnd-stage HCM was identified in 99 (5.4%) patients, averaged at 52 ± 16 years old at entry. Atrial fibrillation was observed in 53 patients and mural thrombus in 19 patients. During 3.9 ± 3.0 years of follow-up, embolic stroke, refractory heart failure, and death or transplantation were observed in 20, 39, and 51 patients, respectively. The incidence of annual mortality was 13.2%. Multivariate Cox hazards regression analysis identified New York Heart Association Class (NYHA) III/IV at entry (hazard ratio [HR]: 1.99; 95% confidence interval [CI]: 1.05-3.80; P = 0.036), left bundle branch block (LBBB) (HR: 2.80; 95% CI: 1.47-5.31; P = 0.002), and an abnormal Q wave (HR: 2.21; 95% CI: 1.16-4.23; P = 0.016) as independent predictors of cardiovascular death, in accordance with all-cause death and heart failure-related death.

CONCLUSIONSLBBB and an abnormal Q wave are risk factors of cardiovascular mortality in end-stage HCM and provide new evidence for early intervention. Susceptibility of end-stage HCM patients to mural thrombus and embolic events warrants further attention.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiomyopathy, Hypertrophic ; diagnostic imaging ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Radiography ; Risk Factors ; Young Adult