OBJECTIVETo evaluate the clinical effects of single posterior debridement, bone grafting, internal fixation and local chemotherapy in treating thoracolumbar spinal tuberculosis.

METHODSFrom February 2009 to September 2012,11 patients with thoracolumbar spinal tuberculosis were treated by single posterior debridement, bone grafting, internal fixation and local chemotherapy. There were 7 males and 4 females, aged from 27 to 65 years old with an average of 53.7 years. The courses of disease was from 3 months to 2 years with the mean of 9 months. According to ASIA standard of spinal cord injury, 3 cases were grade C and 8 cases D. After treatment, clinical effects were evaluated by ASIA grade, visual analogue score (VAS) and Oswestry Disability Index (ODI); kyphosis Cobb angle change was observed by X-rays.

RESULTSEleven patients were followed up from 12 to 29 months with an average of 18 months. ASIA grade of spinal cord injury, 3 patients with grade C improved to grade D in 2 cases and grade E in 1 case 8 patients with grade D improved to grade E in 7 cases and unchanged in 1 case. VAS decreased from preoperative 6.10 ± 1.30 to 1.70 ± 0.80 at 3 d after operation (P < 0.05). ODI improved from preoperative (68.36 ± 10.41)% to (14.55 ± 8.99)% (P < 0.05) at 3 d after operation. Kyphotic Cobb angle was corrected from preoperative (22.64 ± 4.84)° to (4.27 ± 1.49)° (P < 0.05) on the 3rd day after operation, and angle loss was mild at final follow-up, there was no significant difference between postoperative at 3 d and final follow-up.

CONCLUSIONSingle posterior debridement, bone grafting, internal fixation and local chemotherapy for the treatment of thoracolumbar spinal tuberculosis can effectively remove the lesion, improve nerve function and correct deformity, has advantage of single incision, little trauma, and low recurrence rate. But it still need long-term and systemic treatment with anti-TB drugs.

Adult ; Aged ; Bone Transplantation ; Debridement ; Female ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; therapy

OBJECTIVETo investigate and analyze the perioperative prophylactic use of antimicrobial agents in 118 hospitals in China.

METHODS3557 medical records (from September to December, 2006) of 118 hospitals were drawn out randomly. The perioperative prophylactic use of antimicrobial agents was investigated and analyzed.

RESULTSProphylactic antimicrobial agents were used in 3485 cases (98%). The first 3 kinds of antimicrobial agents most in use were cephalosporins of 3rd generation (1775/3485, 50.4%), 2nd generation (1191/3485, 34.2%) and fluoroquinolones (1120/3485, 34.1%). The average durations of antibiotic use were 7.4 d for class I (clean) wounds 7.6 d for class II (clean/contaminated) wounds and 10. 5 d for class III (contaminated) wounds. Only 30.4% of patients received antibiotics within 2 h prior operation, and 52.2% of patients did not received antibiotics until the operation was completed. There were no indications for prophylactic antibiotic use in 16.7% of cases. Combining use of antimicrobial agents were performed in 56.5% of cases, and 22.1% of them lack of reasonable indications.

CONCLUSIONSInappropriate use of perioperative prophylactic antimicrobial agents is common and must be subjected to standardization.

Adult ; Anti-Infective Agents ; therapeutic use ; Antibiotic Prophylaxis ; China ; Drug Utilization Review ; statistics & numerical data ; Hospitals, General ; statistics & numerical data ; Humans ; Perioperative Care ; methods

Objective To discuss the imaging diagnostic features of adrenal injury. Methods The imaging features of the 29 patients of adrenal bruise and hernatoma (20 male and 9 females, average age 37) were retrospectively analyzed. The clinical appearances were all flank and hack pain, local sensitive to percus-sion and associated injury appearance. Among the 29 cases, 25 cases(86%) had adrenal injuries on right side, 2 cases(7%) on left side, and 2 cases(7%) on both sides, and no apparent abnormality was found in the relevant endocrine examination after injury. CT (n=29), MRI (n=5) and ultrasonography (n=6) were checked. CT follow-up were taken in 23 eases. MRI (n=1) and ultrasonography (n=l) were followed as well. Results The first-time exam coincidences of CT, MRI and sonography were 28/29 (97%), 5/5 (100%) and 3/6 (50%) respectively. One case of simple right-side adrenal hematoma 3 weeks after injury wasn't clearly diagnosed by CT, which was later diagnosed by MRI. The CT features of adrenal bruise were local or diffuse intumescence and focus high-density hemorrhage shadow. The CT appearances of acute stage adrenal hematoma were round-like high-density shadow without enhancement and the diameters were 1-3 cm. MRI appearances of 5 cases of subacute and chronic phase hematoma were typical high signal of T1WI, T2WI and DWI and toroid low signal around T2WI. Hematorna was not be enhanced when CT or MRI en-hancement scanning, and formed characteristic "nut-like" image feature with toroid high-density or high sig-nal enhanced shadow forming around. Uhrasonography appearances of 3 cases of hematoma were abnormal shadow of the adrenal gland. Conclusions CT is the prior imaging method for adrenal bruise and hemato-ma. MRI has the characteristic appearance for the few cases which are difficult to be identified by CT and ul-trasonography. Characteristic "nut-like" image feature is helpful for the diagnosis and differential diagnosis.

AIM To study the formation rules of baicalin-berberine complex.METHODS Under the conditions of different ratios of baicalin to berberine,heating methods and media (pH,ionic strength),the yield and composition of mixed decoction precipitation were determined by HPLC.RESULTS 0.5 g Baicalin and 1 g berberine produced the highest amount of precipitation.Higher heating temperature,nearly neutral pH (6.8) and glucose addition were beneficial to precipitate generation,in sharp contrast to NaCl addition.CONCLUSION The yield and composition of baicalin-berberine complex are mainly influenced by heating temperature and additives.

We investigated brucellosis incidence trends in Kashgar,Xinjiang in 2005-2016 for further prevention and control,and analyzed the brucellosis epidemiological characteristics there,by using the descriptive epidemiology method.A total of 767 cases were reported,with an average annual incidence of 1.68/100 000,and incidence of annual report showed a relatively stable trend (Z:29.49,P＜0.001).The maximum number of reported cases was mainly concentrated from May to July.Incidence ratio of the male and female was 1.81:1.Cases were identified in each age group,the minimum age was five months,and the maximum age was 85 years old,with the median of 39.The highest proportion of reported cases was peasant.The top five average annual incidence counties (cities) were the Markit County,Yopurga County,Tashikuergan Tajik Autonomous County,Bachu County and Kashgar City.The brucellosis incidence increased year by year,especially during 2012-2016.We need further analysis for the data from increasing brucellosis outbreak and further strengthen the prevention and control of that in Kashgar area.

The clinical value of transvaginal ultrasound in clinical surgical treatment of cesarean scar pregnancy (CSP) was evaluated.The clinical data of 104 patients with CSP admitted at Tongji Hospital from 2013 to 2016 were collected and analyzed retrospectively,including the patients' age,gestational age,the size of gestational sac or uneven mass,the uterine scar thickness,β human chorionic gonadotropin (hCG) levels and so on.Of these 104 cases,30 cases were subjected to laparotomy,29 cases to laparoscopy,27 cases to hysteroscopy,16 cases to ultrasound-guided uterine curettage,and 2 cases to conservative treatment.The transvaginal ultrasound showed that uterine scar thickness and gestational sac or uneven mass size had significant difference (P＜0.05) among different surgical methods by comparatively analyzing the patients' data.It was suggested that transvaginal ultrasound may provide the valuable reference for choosing clinical surgical procedures for CSP.

OBJECTIVETo investigate the additive effects of uncoupling protein 2 (UCP2) gene Ala55Val variation and ADR beta(3) gene Trp64Arg variation on the obesity in Chinese Han population.

METHODSThe UCP2 gene Ala55Val variation and ADR beta(3) gene Trp64Arg variation were examined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) in 119 obese subject with mean BMI (27.9+/-2.98)kg/m(2) and in 177 control subjects with mean BMI(21.9+/-1.9)kg/m(2). The additive effects of the two gene mutations were analyzed.

RESULTS(1) The frequency of ADR beta(3) gene Trp64Arg variation in obese subjects was not significantly different from that in control subjects. In control subjects, the Trp64Arg variation carriers had higher fasting glucose level and 2-hour-post-prandial glucose level than did non-carriers. (2) The frequency of homozygote of UCP2 gene Ala55Val variation in obese subjects was higher than that in the control subjects (OR=3.71, P=0.001). In control subjects the Ala55Val variation carriers had higher BMI. (3) When there was only UCP2 gene or ADR beta(3) gene mutation, the frequency of gene mutation in obese subjects was not significantly different from that in control subjects (P>0.05). But when there were simultaneously two gene mutations, the frequency of gene mutations was higher in obese subjects than in control subjects (OR=2.57, P=0.009). (4) The genotype carriers with Val/Val+ Trp/Arg were the greatest relation to obese obesity (OR=8.58, P=0.002).

CONCLUSIONThe homozygote of UCP2 gene Ala55Val mutation increases the risk of obesity. Though the UCP2 gene mutation alone or the ADR beta(3) gene mutation alone is not associated with obesity, the possible additive effects of the two micro-genes increase the occurring of obesity.

Adult ; Aged ; Female ; Humans ; Ion Channels ; Male ; Membrane Transport Proteins ; genetics ; Middle Aged ; Mitochondrial Proteins ; genetics ; Mutation ; Obesity ; genetics ; Receptors, Adrenergic, beta-3 ; genetics ; Uncoupling Protein 2

To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in people with subhealth fatigue.

OBJECTIVETo observe the protective effect of Acanthopanax senticosus saponins (ASS) on myocardial ischemia-reperfusion injury in rats.

METHODThe myocardial ischemia-reperfusion model was induced by 30 min left anterior descending coronary occlusion and 120 min reperfusion in rats. The changes of myocardial infarct size (MIS), the serum creatine phosphokinase (CK) and lactate dehydrogenase (LDH) activity, the serum lipid peroxidation (LPO) content and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity and plasma endothelin (ET), angiotensin II (Ang II), prostacycline (PGI2) and thromboxane A2 (TXA2) levels and myocardial free fatty acid (FFA) content of infarct and noninfarct area were determined.

RESULTIn rats treated by ASS (in a dosage of 25, 50 and 100 mg x kg(-1) i.v. at 30 min after coronary occulusion), the MIS was significantly reduced, the serum CK and LDH activity, the plasma ET, Ang II and TXA2 level and myocardial FFA content declined, while plasma PGI2 level and PGI2/TXA2 was increased signficantly. In addition, serum LPO content declined, SOD and GSH-Px activity were increased markedly.

CONCLUSIONASS has protective effect on myocardial ischemia-reperfusion injury, which may be due to its function of improving free radicals and myocardial metabolism, decreasing plasma ET, Ang II and TXA2 levels and increasing plasma PGI2 level and PGI2/TXA2 ratio etc.

Animals ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Eleutherococcus ; chemistry ; Female ; Male ; Myocardial Reperfusion Injury ; metabolism ; pathology ; Myocardium ; metabolism ; pathology ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Saponins ; isolation & purification ; pharmacology

OBJECTIVETo investigate the availability of serum level of macrophage clony stimulating factor (M-CSF) as a marker for early diagnosis of Alzheimer's disease (AD).

METHODSThe serum levels of M-CSF in 70 patients with AD, 52 healthy controls, 22 patients with VAD (vascular dementia) were measured and the serum levels of IL-1 beta, IL-6, TNF-alpha in 32 patients with AD and 20 controls were measured as well.

RESULTSSerum levels of M-CSF were significantly elevated in patients with AD when compared with healthy controls (P < 0.01) and VAD controls (P < 0.05) respectively. At the early stage of mild dementia and middle dementia, serum levels of M-CSF were significantly elevated, but at the later stage of severe dementia, they returned to normal level. Serum levels of IL-1 beta were significantly elevated in AD patients compared with controls (P < 0.05), and serum levels of TNF-alpha and IL-6 were within the normal range in patients with AD.

CONCLUSIONSThe results suggest that serum M-CSF level may provide a convenient and sensitive means for the early diagnosis of Alzheimer's disease.

Aged ; Aged, 80 and over ; Alzheimer Disease ; blood ; Biomarkers ; blood ; Female ; Humans ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Macrophage Colony-Stimulating Factor ; blood ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; metabolism