[Objective]To discuss the alterations of sesamoid position before and after opertation and its relation to the function of the metatarsophalangeal joints.[Methods]Eighty feet(39 hallux valgus feet,41 normal foot) were selected.The distance from sesamoids to the second metatarsal,the relative position of sesamoid bone to the first metatarsal bone,the function of the first metatarsophalangeal joints were determined and analyzed.[Results]The distance from sesamoid to the second metatarsal had no statistical significance in normal feet compared with the hallux valgus feet(P

Objective To evaluate the dynamic MR imaging findings of peripheral cholangiocarcinoma (PCC) of the liver. Methods Seventeen patients with PCC underwent dynamic MRI during the early, middle, and delayed phase after contrast medium administration. Enhancement pattern of the tumor, the wedge-like enhancement area peripheral to the tumor, dilatation of the intrahepatic biliary ducts, vascular involvement, and extrahepatic tumor invasion were evaluated. Results Early peripheral enhancement with progressive and concentric filling by contrast medium was the most frequent enhancement pattern (9 patients). A wedge-like enhancement area was observed in 10 patients. Ductal dilatation was found in 11 patients. Vascular involvement and extrahepatic invasion were seen in 8 and 2 patients, respectively. Conclusion Enhancement pattern is relative to the character of pathology (quantity and distribution of cell and fibrosis). Early peripheral enhancement with progressive and concentric filling by contrast medium may be specific for PCC.

AIM:To observe the effect of lidocaine to the activation of NF-?B and apoptosis in human neutrophils(PMN)in vitro.METHODS:Human PMN were divided into five groups:control group(0.9% sodium chloride);TNF-?(200 ng/L);TNF-?+lidocaine(1.0 mmol/L);TNF-?+lidocaine(2.0 mmol/L),and TNF-?+ lidocaine(4.0 mmol/L).The expression of NF-?B subunit p65 mRNA in the nuclear and I-?B mRNA in the cytosol extracts were analyzed by Western blotting,after co-incubation for 3 h and the content of p65 protein were observed by RT-PCR.PMN apoptosis was detected on flow cytometry after co-incubation 12 h and 24 h.RESULTS:The expression of NF-?B mRNA was significantly decreased and the expression of I-?B mRNA was markedly increased in lidocaine groups(P

Background and purpose:Although FDG tumor imaging has been applied in clinic widely, dual-phase imaging can provide much more information about the FDG uptaking of pulmonary lesions. The purpose of the study was to evaluate the usefulness of dual-phase18F-FDG coincidence detection SPECT/CT imaging in the differential diagnosis of the pulmonary lesions.Methods:There were 28 patients with pulmonary lesions which were detected by CT. All the patients undertook the SPECT/CT imaging at 2 time-phases respectively: early imaging at 40-60 min and delayed imaging at 2-3 h after the intravenous injection of FDG. Data processing: calculating the radio of T and N in early and delayed imaging respectively; T: The radioactive count of the lesions; N: The radioactive count of the normal tissue; and the change rate:ΔT/N. ROC was used to ifnd out the threshold of T1/N1, T2/N2及ΔT/N in the differential diagnosis between benign and malignant lesions. AUC was used to evaluate the diagnosis value of the dual-phase and single-phase imaging.Results:The threshold of T1/N1 in early imaging was 2.65, whereas AUC was 0.767. The sensitivity, speciifcity and accuracy were 83.3%, 30% and 64.3%, respectively. The threshold of T2/N2 in delayed imaging was 3.14, whereas AUC was 0.847. The sensitivity, speciifcity and accuracy were 94.4%, 60.0% and 82.1%, respectively. The threshold ofΔT/N in delayed imaging was 16.9%, whereas AUC is 0.950. The sensitivity, speciifcity and accuracy were 88.5%, 71.4% and 86.2%, respectively.Conclusion:Dual-phase18F-FDG coincidence detection SPECT/CT imaging has much higher accuracy and speciifcity. However it still has false positivity, and should be analyzed with CT and clinical history.

Objective To evaluate the role of spinal nicotinamide-adenine dinucletide phosphate (NADPH) oxidase in the development and maintenance of neuropathic pain (NP) in rats.Methods Twenty-four pathogen-free healthy male Sprague-Dawley rats,aged 200-250 g,were divided into 3 groups (n =8 each) using a random number table:sham operation group (S group),NP group and NADPH oxidase inhibitor group (NI group).The left sciatic nerve was exposed but not ligated in group S.The left sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread to establish the NP model in group NP.In group NI,the NP model was established at 3 days after intrathecal catheterization,and NADPH oxidase inhibitor 5 μg/10 μ1 was injected intrathecally once a day for 7 consecutive days starting from 30 min before operation.The mechanical paw withdraw threshold (MWT) was measured at 1 day before operation and 1,3,5 and 7 days after operation.The rats were sacrificed at 8 days after operation,and the spinal cord was removed for determination of NeuN positive cells (by immuno-histochemistry) and expression of NADPH oxidase (by Western blot).Results Compared with group S,the MWT at each time point after operation and ratio of NeuN positive cells at 8 days after operation were significantly decreased in NP and NI groups,the expression of NADPH oxidase was upregulated in group NP,and the expression of NADPH oxidase was down-regulated in group NI (P＜0.05).Compared with group NP,the MWT at each time point after operation and ratio of NeuN positive cells at 8 days after operation were significantly increased,and the expression of NADPH oxidase was down-regulated in group NI (P＜0.05).Conclusion Up-regulated expression of spinal NADPH oxidase is involved in the development and maintenance of NP in rats.

Doctor-patient trust plays an important role in doctor-patient knowledge transfer.Investigating the basic features and trust performance of the patients, the authors classified by means of a cluster analysis, the patients into four groups with such criteria as the trust on hospital, trust on doctors, patient's awareness of the knowledge, and patient's compliance to the doctor's advice. The four groups are rational and suspicious, passive compliance, high self-confidence, and blind trust groups. In view of behavioral characteristics of the patients, different doctor-patient knowledge transfer strategies are suggested, in an effort to perform effective doctor-patient communication and to gain patient's trust.

Objective To study the effects of ETP-508,a novel endothelin receptor antagonist,on the proliferation of pulmonary arterial smooth muscle cells(PASMCs) of rat cultured in hypoxia environment.Methods Primary culture of rat PASMCs was prepared by the method of tissue block anchorage,and they were assigned into four groups: normoxia group(21% O2),hypoxia group(2% O2),hypoxia+BQ-485 group(10-6,10-7,10-8,10-9mol/L) and hypoxia + ETP-508 group(10-6,10-7,10-8,10-9mol/L).MTT(492nm) assay was used to detect the A value of the four groups after cells were cultured for 24,48 and 72h.Flow cytometry and radioimmunoassay were respectively used to detect the cell cycle and ET-1 content at 48h time point.Results MTT assay demonstrated that A value of each group did not significantly differ at 24h time point.At 28h time point,A value of hypoxia group was markedly increased(P

Objective To evaluate the efficacy of ultrasound?guided transversus abdominis plane ( TAP) block with different concentrations of ropivacaine for analgesia after cesarean section. Methods A total of 120 parturients, aged 24-31 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, weighing 64-73 kg, at 35 to 41 week gestation, scheduled for elective cesarean section, were randomly di?vided into 3 groups ( n= 40 each) using a random number table: 0?25% ropivacaine group ( group Ⅰ) , 0?20% ropivacaine group ( groupⅡ) , and 0?15% ropivacaine group ( groupⅢ) . A patient?controlled an?algesia pump was connected at the end of surgery, and the corresponding concentration of ropivacaine 1?5 mg∕kg was injected into the bilateral TAP under the guidance of ultrasound in each group. Visual analogue scale score was maintained ≤3. The number of attempt and the number of patients requiring rescue analge?sic were recorded at 48 h after surgery. The occurrence of TAP block?related complications was observed and recorded. Results Compared with groupⅢ, the number of attempt and the number of patients requi?ring rescue analgesic were significantly decreased in Ⅰ and Ⅱ groups ( P<0?05 ) . Compared with groupⅡ, the number of attempt and the number of patients requiring rescue analgesic were significantly de?creased in group Ⅰ (P<0?05). No TAP block?related complications were detected in the three groups. Conclusion Ultrasound?guided TAP block with 0?25% ropivacaine is helpful in improving the analgesic efficacy after cesarean section without serious complications.

Objective To study the clinical manifestation,treatment and prognosis of patients with primary Sjgren′s syndrome and renal tubular acidosis.Methods Sixty patients who were diagnosed as pSS complicated with RTA during the last 13 years were retrospectively analyzed and followed up for 7 5 years on average.Results Distal renal tubular acidosis ( n =53,83 3%) was much more frequeut than the proximal one ( n =7,11 7%).Hypokalemic paralysis,diabetes insipitus,and calcification of the renal tissue appeared in 49 patients (92 4%).Glomerular lesions were found in 12 of the 15 patients who underwent kidney biopsy.Renal insufficiency was developed subsequently in 4 out of 5 patients with glomerular sclerosis.Abnormal serum creatinine was detected in 11 patients (18 3%),and in 7 of them it persisted 11 5 years on average after the onset of RTA.Two of them died from renal failure and 1 received hemodialysis.Hypergammaglobulinemia was more obvious in the patients with renal insufficiency than those without ( P

Endoplasmic reticulum stress,an critical component of cell stress,is a protective response for eukaryotic cells. The change of partial pressure of oxygen (for instance hypoxia) is a primary condition for cell stress,significantly impacting the biological phenotype and behavior of cells (including survival,migration and invasion et al). Through endoplasmic reticulum stress,intracellular concentration of unfolded protein is reduced,and agglutination inhibited. Recently,endoplasmic reticulum stress has been demonstrated to play an important role in pathogenesis of some diseases such as cancer,diabetes and inflammation,which are characterized by the micro-environment hypoxia in local tissue. Therefore,investigations on the mechanism of endoplasmic reticulum stress caused by hypoxia may promote the novel therapeutic strategy for tumors,cardiovascular diseases and diabetes.