Objective To detect the difference of the light sensitivity in the central visual field between normal people and type Ⅱ diabetic patients without diabetic retinopathy , and evaluate the effect of perimetric examination in early diagnosis of diabetic retinopathy. Methods The light sensitivity at the 80 locations in the central field was measured by Dicon field analyzer (model TKS 4000) in 76 normal eyes of 44 normal volunteers aged from 45 to 72 years and 75 eyes of 40 type Ⅱ diabetic patients without retinopathy aged from 46 to 71 years. Results For the diabetic patients without diabetic retinopathy, the light sensitivity of locations decreased by 4 8 dB,and there were some decreased light sensitivity areas. The mean light sensitivity of three zones of the central field had significant reduction in the diabetic patients as compared with the control group( P

Objective To investigate the clinical characteristics of compression of upper trunk brachial plexus.Methods Clinical data of 27 patient with compression of upper trunk brachial plexus were retrospective analyzed.Results All cases showed sensory disturbance in radialis sides of upper extremities.13 cases accompanied by ipsilateral breast or mid-back pain.All cases showed severe tenderness at the middle point or at the juncture between center and lower third part of posterior edge of the ipsilateral sternocleidomastoid muscle.The tenderness always radiated to the involvement limb,the affected breast or the mid-back areas.Symptoms aggravated in 55.6%(15/27)cases when the suffering limbs were set in abducens and rotated externally position.25.9%(7/27)cases showed decreased nerve conduction velocities and 7.4%(2/27)showed abnormal motor unit potential.Radioactive ray studies found no abnormalities corresponding to the symptoms.Nerve blockade at the tenderness point together with physiotherapy were effective.4 weeks after treatment the total effective rate was 82.5%(23/27),ineffective rate was 14.8%(4/27).Conclusions The features of upper trunk brachial plexus entrapment neuropathy including:paraesthesia in radialis side of upper extremities and severe tenderness at the middle or center-lower part third of posterior edge of ipsilateral sternocleidomastoid muscle which radiates to the involvement limb,mid-back or breast.Local nerve blockade combined with physiotherapy was effective,and also one of the way for differential diagnosis.

Objective To establish an HPLC method for the determination of Aloeemodin,Rhein,Chrysophanol,Emodin and Physcione in Huangxiong Kangshuan Capsule.Methods The determination was performed on Kromasil-C18 column(250 mm?4.6 mm,5 ?m) with mobile phase consisted of methanol-0.1% phosphoric acid(85:15) at a flow rate of 1.0 mL/min.Column temperature was 25 ℃.The UV detection wavelength was set at 254 nm.Results The calibration curves were linear in the range of 0.230～3.68 ?g(r=0.999 8) for Aloeemodin,0.224～3.584 ?g(r=0.999 9) for Rhein,0.223～3.568 ?g(r= 0.999 8) for Emodin,0.257～4.112 ?g(r=0.999 9) for Chrysophanol and 0.287～4.592 ?g(r=0.999 8) for Physcion.The average recovery was 98.48%,98.10%,99.08%,100.34%,97.52% and RSD was 1.39%,1.54%,1.44%,2.40%,2.03% respectively.Conclusion The determination method is simple,reliable,accurate,and it can be used for quality control of Huangxiong Kangshuan Capsule.

Benzoates ; urine ; Gas Chromatography-Mass Spectrometry ; methods ; Humans

Objective To explore the aesthetic effect of the applying the expanded skin flap to re-pair facial defects produced by removal of nevus, hemangioma, scars and so on. Methods The experience of the treating 67 patients with facial lesions using the expanded flaps were reviewed. The proper expand-ers were chosen according to the scope of the facial lesion. The incision was located at the scar region and the dissection was executed in the superficial layer of the SMAS. The interspace was larger than the ex-pander by 1.0～1.5 cm. After exact hemostasis, the expanders and negative pressure drainage tubes were placed into the interspace. The design of the facial expanded skin flap included the advance, rotation, and transposition of skin flap and so on. The advance of skin flap took fully use of the expanded skin flap without the donor site defect. The transposition of skin flap also took fully use of the expanded skin flap, furthermore, it overcame the displacement and the disfiguration caused by the applying of the advance skin flap and rotation skin flap. The incisions in face were designed to a minimal extent and parallel to the Lan-ger line. Results All of the 67 cases got aesthetic satisfied results with all the flaps surviving. Conclusion The application of expanded skin flaps is proved to be an effective way of repairing facial wound when there is enough normal facial skin for expansion.

BACKGROUND: Aldosterone is an important pathogenic factor of left ventricular hypertrophy. There has been evidence that the extract of red sage root (a Chinese herb) can intervene the synthesis of aldosterone.OBJECTIVE: To investigate the effects of tanshinone Ⅱ A on expression of genes related to aldosterone synthesis in myocardium. DESIGN:A randomized and controlled trial. SETTING :Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. MATERIALS:The experiment was performed at the laboratory of Emergency Department, Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from November 2002 to March 2004. Totally 20 male 12-week-old rats with spontaneous hypertension were randomly divided as hypertension group and tanshinone Ⅱ A group. METHODS:Rats in each group were injected tanshinone Ⅱ A or distilled water in the same volume respectively through caudal vein. After 12-week administration,the rats were put to death by decapitation, and the samples of myocardium were prepared. The expressions of CYP11B1mRNA and CYP11B2 mRNA, or myocardial genes related to aldosterone synthesis were examined with reverse transcriptase polymerase chain reaction (RTPCR) and referring to the amplification primers of glyceraldehydes 3-phosphate dehydrogenase (GAPDH) gene. MAIN OUTCOME MEASURES:The levels of CYP11B1 and CYP11B2 mRNA related to aldosterone synthesis in myocardium.RESULTS :Totally 20 rats were involved in the trial and all entered in the final result analysis without any loss of value. ① Quantitative analysis of expression of myocardial CYP11B1 and CYP11B2 genes in rats of two groups: Taking 100bp Plus Ladder as Marker,clear amplified strands could be seen at 440bp,461bp and 336bp sites,DNA sequencing proved they were the encoding gene segments of CYP11B1,YP11B2 and GAPDH. ②Qualitative analysis of expression of myocardial CYP11B1 and CYP11B2 genes in rats of two groups:The expressive levels of CYP11B1 and CYP1 1B2 mRNA contents in tanshinone Ⅱ A group were significantly lower than those in hypertension group (0.924±0.121 vs 1.343±0.132,P ＜ 0.05;1.017±0.119 vs 1.675±0.126,P 0.01). CONCLUSION:Tanshinone Ⅱ A could directly down-regulate the expression of CYP1 1B1 and CYP1 1B2 mRNA, the genes related to aldosterone syn thesis, so that it inhibited the biological synthesis of aldosterone in myocardinm, thus playing a role to resist hypertensive left ventricular hypertrophy.

Objective To discuss how to use the core elements of international classification of functioning,disability and health(ICF) as a guide in stroke operation treatment to develop targeted,effective therapy plan and rehabilitation goals,establish individualized treatment of rehabilitation,and to observe the effect of limb movement function in stroke patients. Methods Sixty cases patients with stroke and aged from 40 to 65 years old were selected. The body function and structure of all stroke patients were marked by comprehensive evaluation scores of The National Institutes of Health Stroke Scale ( NIHSS ) and Fugl?Meyer assessment. And then they were randomly divided into two groups,30 cases in each group. The observation group used the Chinese version of brief ICF Core Sets for evaluation, and set individualized treatment according to the results of the assessment;The control group, according to the conventional rehabilitation process, involved in training routine physical therapy. Again 8 weeks after treatment for patients with evaluation,the assessment results was compared with the results of the first assessment. Results Before treatment, the NIHSS, Fugl?Meyer assessment and Chinese version of brief ICF core elements scale scores for the observation group were 7. 95±2. 37,34. 5±4. 0 and 82. 15±17. 96,for the control group were 7. 58±2. 25,34. 8±4. 0 and 81. 55±18. 78. After treatment,the above three rating scale scores, for the observation group were improved to 4. 78 ± 1. 63, 56. 3 ± 4. 2, 60. 45 ±11. 04,for the control group were improved to 5. 13±1. 75,48. 1±3. 8,73. 56±16. 89. The two groups were significantly improved ( observation group:t=4. 94, 15. 51, 18. 59, P<0. 05;control group:t=3. 17, 14. 66, 12. 33,P<0. 05). After treatment,compared with the control group of three rating scale scores(5. 13±1. 75,48. 1
±3. 8 and 73. 56±16. 89),the observation group(4. 78±1. 63,56. 3±4. 2 and 60. 45±11. 04) improved more apparently(t=3. 15,14. 54,15. 45,P<0. 05) . Conclusion Guided by the idea of ICF and scale,with the demand of the patients as the center,to develop personalized physical therapy,can achieve more productive and more targeted rehabilitation goals.

Objective To discuss the cause,treatment and prevention of splenic injury during the urological surgery.Methods The clinical data of 16 cases with splenic injury in operation for renal and adrenal tumors in 496 cases were retrospectively analyzed.Nine cases were left radical nephrectomy,3 cases were left renal hamartoma enucleation,4 cases were left adrenal tumor resection.Damage located at outer edge of the spleen in 8 cases,the splenorenal ligament in 6 cases,and the splenic hilum in 2 cases.In these 16 cases,14 patients spared the spleen (Ⅰ Grade injury 8 cases,Ⅱ grade 6 cases).The injuryed spleen was directly pressed with hemostatic gauze in 3 cases; 5 patients used coagulation,bonding,hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injury used U-shaped suture and coated with fibrin glue,then compressed with hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injuries with the greater omentum stitched into the seam,sprayed biological glue,were compressed with gelatin sponge; 2 cases of grade Ⅱ injury underwent splenic artery branch ligation.The other 2 cases (1 Ⅱ grade and 1 Ⅲ grade) underwent splenectomy.Results All of the 16 patients were cured and followed up for 6 months to 5 years.There was no delayed bleeding of spleen and splenic dysfunction.One patient died of tumor recurrence 6 months after operation.Conclusions Splenic injury is a common complication during urological surgery,especially the tumor is large or adhered to spleen in the upper pole of left kidney.Once spenic injury occurs,doctors should choose the right treatment plan according to surgical injury,and try to save the spleen.

Objective To study the clinical characteristics and outcome of cytomegalovirus(CMV) infection in infants.Methods All data including time of infection,clinical characteristics,laboratory tests and outcome of CMV infections in hospitalized infants were collec-(ted) and analyzed from January,1994 to July,2004.Results In 87 infected infants,congenitally infected newborns,perinatal infection in infants and postnatal infection in infants accounted for 27.6%,62.0%,16.6%,respectively.CMV hepatitis was the most frequent type of disease with the incidence of 41.3%,in which the incidence of splenomegaly was 10.3%.Most of CMV hepatitis infants had a good prognosis with the improved rate 80.5%.Central nervous system abnormality(including abnormal intension of muscle,convulsion,ocular and hearing abnormalities) occurred only in congenital and perinatal infection with the incidence of 20.4%.Generalized infection,the incidence of congenital infection and perinatal infection was 16.7%,1.8%,respectively.It did not occur in postnatal infection.The mortality rate of congenital infection and perinatal infection were 12.5% and 1.85%,respectively.Conclusions CMV infection is the main cause of infant hepatitis and it can also cause neurologic sequelae.The outcome of generalized infection in congenital infection is bad and the mortality rate is high.

Objective To study the relationship of levels of circulating endothelial microparticles (EMP62E, EMP31) and high-sensitivity C-reactive protein (hs-CRP) with severity of chronic left heart failure in elderly patients. Methods According to New York Heart Association (NYHA) class and left ventricular ejection fraction (LVEF), the healthy subjects and the patients were divided into five groups: control group [LVEF: (63.97±4.65)%], classⅠ group [LVEF: (42.67±2.06)%], classⅡ group [LVEF: (34.26±3.17)%], class Ⅲ group [LVEF: (29.05±1.07)%] and class Ⅳ group[ LVEF:(25.17±1.42)%] . The levels of circulating EMP62E, EMP31 and hs-CRP of the patients and healthy subjects were measured by flow cytometry and nephelometry immunoassay, respectively. Results There were significantly differences in EMP62E, EMP31 and hs-CRP between class Ⅳ group and classⅠ group P＜0.01) EMP62E [(1092.7 ± 102.8) counts/μl vs. (291.0±21.9) counts/μl], EMP31 [(1596.1±46.3) counts/μl vs. (477.8±40.3) counts/μl] and hs-CRP [(14.74±0.07) mg/L vs. (4.86 ± 0.09) mg/L]. The levels of circulating EMP62E, EMP31 and hs-CRP were gradually elevated significantly along with the increased severity of chronic left heart failure in elderly. Conclusions The upregulation of circulating EMP31, EMP62E and hs-CRP may contribute to the development of chronic heart failure in elderly.