Objective To present the diagnosis and treatment of functional bladder outlet obstruction and to assess the results of transurethral bladder neck incision and alpha-blockers with regard to symptoms and urodynamic findings. Methods From October 1995 to October 2002,39 male patients (age range from 24 to 48 years,with a mean of 37 years) who had dysuria and underwent urodynamic examination,cystourethrography and urethral exploration were diagnosed with functional bladder outlet obstruction.The mean IPSS was 22.5.The mean maximum urinary flow rate was 10.2 ml/s and the mean residual volume was 124 ml.All the patients were treated with transurethral incision of bladder neck and alpha blockers. Results The mean operative duration was 15 min;mean blood loss was 50 ml;mean postoperative hospital stay was 3.5 d.During 1-year follow-up,most of the patients were satisfied with the treatment results.Subjective assessment showed a statistically significant reduction of the voiding complaints.The mean IPSS was 10.1 .The mean maximum urinary flow rate was 22.1 ml/s (range,12.7 to 42.1 ml/s) and the mean residual volume was 49 ml (range,0 to 84 ml). Conclusions Urodynamic examination,voiding cystourethrography and urethral exploration with dilator facilitate the diagnosis of functional bladder outlet obstruction.Treatments with transurethral incision of the bladder neck and alpha-blockers are effective and safe for functional bladder outlet obstruction.

Objective To investigate the analgesic efficacy and spinal neurotoxicity of intrathecal (IT) different doses of dexmedetomidine in rats. Methods Sixty male SD rats weighing 180-220 g were randomly divided into 5 groups ( n = 12 each): groupnormal control (group C); group IT normal saline (group N); different doses of dexmedetomidine groups received IT dexmedetomidine 0.75, 1.50 and 3.00 μg/kg respectively (groups D1.3). Paw withdrawal threshold to mechanical stimulation (PWMT)with yon Frey filaments and tail flick latency (TFL) to a thermal nociceptive stimulus were measured before (To, baseline) and at 30 or60 rin after IT dexmedetomidine or normal saline administration (T1, T2 ) and the percentage of the maximum possible effect ( MPE ) was calculated. Lumbar segment of the spinal cord ( L4-6 ) was removed for microscopic examination and determination of c-Fos expression (by immuno-histochemistry) at 7, 24 and 48 h after IT dexmedetomidine or normal saline administration. Results PWMT, TFL and the percentage of MPE were significantly increased after IT dexmedetomidine as compared with the baseline values at T0 in groups D1-3 ( P ＜ 0.05). PWMT was significantly higher at T1 and TFL and the percentage of MPE were higher at T2 in groups D1-3 than in groups C and N,and in group D3 than in groups D1,2 ( P ＜ 0.05). At 7,24 h after IT dexmedetomidine c-Fos protein expression was significantly higher in group D3 than in groups C and N( P ＜ 0.05). There was no significant difference in c-Fos expression at 48 h after IT dexmedetomidine between group D3 and groups C and N ( P ＞ 0.05 ). At 24 h after IT dexmedetomidine c-Fos protein expression was significantly higher in group D3 than in other 4 groups( P ＜ 0.05). Slight spinal cord injury was observed at 24 h after IT dexmedetomidine in group D3. Conclusion IT dexmedetomidine has antinociceptive effect. High dose dexmedetomidine IT can produce transient reversible toxicity to the spinal cord.

0.05), but radioactivity counting ratio of before and 2 years after operation wassignificantly lower than operation after 1-12 months (P 0.05). CONCLUSION: Automated ROI setting findings show that moderate load-bearing for patients with femoral neck fracture is favor to femur neck fracture healing and bone reconstruction.

BACKGROUND:There is evidence that internal fixation through an anterior or posterior approach for treatment of severe kyphotic deformity in spinal tuberculosis exhibits good curative effects. However, few prospective, long-term fol ow-up case control studies are reported. OBJECTIVE:To investigate the efficacy and safety of cobalt al oy pedicle screw implantation for treatment of severe kyphotic deformity in spinal tuberculosis. METHODS/DESIGN:This is a prospective, single-center, self-control, open-label trial, which wil be performed at the Affiliated Hospital of Hebei University, China. Eighty-four patients with severe kyphotic deformity in spinal tuberculosis wil be included according to the diagnosis criteria. Among 52 patients with tuberculosis of the thoracic spine, 28 wil undergo surgery through a posterior approach, and 24 through an anterior approach. According to the Frankel Grade classification, grade C, D and E spinal cord function wil be assessed in 8, 31 and 13 patients, respectively. Surgery through a posterior and anterior approach wil be respectively performed in half of 32 patients with tuberculosis of the lumbar spine. Grade C, D and E spinal cord function wil be assessed in 7, 14 and 11 patients, respectively. The primary outcome measure of this study wil be the Cobb angle at the thoracic spine segments before and 2 years after surgery, which wil be used to evaluate the angle of the spine curvature at the thoracic segments. The secondary outcome measures wil be X-ray scan or MRI findings before and 2 years after surgery, which wil be used to evaluate vertebral fusion after internal fixation;and Frankel Grade before and 2 years after surgery, which wil be used to evaluate recovery of spinal cord function after injury. Other outcome measures wil include multiple logistic regression analysis results of the factors that influence patient's curative effects and the incidence of adverse events 2 years after surgery. The trial protocol has been approved by the Ethics Committee, Affiliated Hospital of Hebei University, China and wil be performed in strict accordance with the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding the trial protocol wil be obtained from each participant. DISCUSSION:This study is to validate that cobalt al oy pedicle screw implantation shows precise curative effects in the treatment of severe kyphotic deformity in spinal tuberculosis and to analyze through what approach, posterior or anterior, internal fixation wil be more beneficial to surgery performance. The outcomes of this study wil provide objective long-term fol ow-up evidence for internal fixation treatment of severe kyphotic deformity in spinal tuberculosis in the clinic.

The complex level of constructing biopharmaceutics classification system of Chinese materia medica CMMBCS) was the study of traditional Chinese compound, on the premise of insisting that the multicomponent simultaneous determination, when carrying out the study of intestinal permeability, the primary task was to define the source of the components that was absorbed through the intestinal wall, namely, which medicinal material the components belonged to in traditional Chinese compound. The technology of chemical fingerprint and in vitro everted gut sac model were used in this research to make multicomponent an intuitive source attribution which permeated the intestine in the classic formula Gegen Qinlian decoction, and to lay the foundation for the further qualitative and quantitative research of intestinal permeability.
Animals ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Intestines ; metabolism ; Male ; Permeability ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar

Objective To observe analgesia effect of morphine hydrochloride and hydromorphone hydrochloride in patients after transurethral resection of prostate. Methods Patients after transurethral resection of the prostate (TURP) were randomly divided into 2 groups, morphine hydrochloride group (n=45) and hydromorphone hydrochloride group (n=47). Analgesia, sedation efficacy and adverse reactions were evaluated at 6 and 24 h after they received epidural postoperative analgesia by using VAS score and Ramsay score. Results In 6 h, hydromorphone hydrochloride group had a better pain tolerance and feeling than morphine hydrochloride group (P<0.05) [(2.9±0.3) score vs.(1.3±0.2) score, (2.4±0.3) score vs. (0.9±0.2) score].However, in 6-12 h, the results were on the contrary (P<0.05) [(3.4±0.3) score vs.(5.4±0.3) score, (3.3±0.2) score vs. (5.7±0.4) score].After 24 h, there was no difference between the two groups (P>0.05).There were no differences in adverse reactions between the two groups ( P>0. 05 ) . Conclusion Hydromorphone has a better effect than morphine in epidural analgesia in 6 h.

BACKGROUND:Choosing internal fixator implants with good strength and stiffness is the key to repair femoral neck combined with ipsilateral subtrochanteric fractures. OBJECTIVE:To compare the biomechanical properties of different implant fixation for femoral neck combined with ipsilateral subtrochanteric fractures. METHODS:Totaly 24 adult antiseptic cadaver specimens were used to produce fracture models with femoral neck fracture combined with 5 cm of ipsilateral subtrochanteri medical cortical defect, and were divided into femoral proximal locking plate group, lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group according to the random number table method. The results of axial compression test, torsion test and axial compression failure rest in three groups were compared. RESULTS AND CONCLUSION: The axial compressive stiffness and failure load in lengthening proximal femur anti-rotation intramedulary nail group were significantly greater than those in femoral proximal locking plate group and lengthening proximal femoral nail group, and those in lengthening proximal femoral nail group were significantly greater than those in femoral proximal locking plate group (P < 0.05). The torsional stiffness in femoral proximal locking plate group was significantly greater than that in lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group, and that in lengthening proximal femur anti-rotation intramedulary nail group was significantly greater than that in lengthening proximal femoral nail group (P < 0.05). The indexes of biomechanical properties of specimens at the 4thand 8th weeks after fixation in three groups were slightly increased compared with those in 0 week after surgery, but the difference was no statisticaly significant (P > 0.05). These results demonstrate that to a certain extent, compared with the femoral proximal locking plate and lengthening lengthening proximal femoral nail, lengthening proximal femur anti-rotation intramedulary nail fixation for repair of femoral neck combined with ipsilateral subtrochanteric fractures has more biomechanical advantages.

BACKGROUND:Proximal humeral fractures are commonly treated by open reduction and internal fixation, which greatly injuries tissue and noticeably damages local blood supply. However, with the development of material and progress of repair method, complications have obviously reduced. OBJECTIVE: To compare the difference of locking plate and ordinary steel plate in the repair of proximal humeral fractures. METHODS:A total of 68 patients with great displacement and comminuted proximal humeral fractures, who were treated in the Department of Orthopedics, Affiliated Tongren Hospital, Shanghai Jiao Tong University School of Medicine from February 2012 to October 2014, were enroled in this study. According to fixation method, they were divided into two groups. 32 cases in the locking plate group were subjected to locking plate, and 36 cases in the ordinary steel plate group received fixation with T type plate and Clover plate. They were folowed up at the out-patient clinic at 2, 4, 6, 12 and 24 weeks after treatment. The satisfaction rate of shoulder function treatment was assessed using Neer scoring system. They received reexamination before withdrawal of fixator. The incidence of complications was observed in patients. RESULTS AND CONCLUSION: The satisfaction rate was significantly lower in the ordinary steel plate group than in the locking plate group (75%, 81%,P < 0.05). No screw and plate breakage, shoulder seam impact,humeral head necrosis or infection was found in the locking plate group. Six cases suffered from pain. In the ordinary steel plate group, there were screw and plate breakage in five cases, shoulder seam impact in five cases, pain in eight cases, humeral head necrosis in two cases and infection in two cases. The incidence of complications was significantly greater in the ordinary steel plate group than in the locking plate group (P < 0.05). These data suggest that locking plate can be used as the first choice for internal fixation in treatment of proximal humeral fractures. No matter satisfaction rate of repair or complications, it is better than ordinary steel plate fixation.

BACKGROUND:Hip fracture has become one of the main reasons for morbidity, death and heavy medical costs in the elderly. With aging, the incidence of hip fractures in the elderly is increased day by day. OBJECTIVE:To investigate and analyze the incidence and distribution of hip fractures in middle-aged and old population from Changning District of Shanghai, China. METHODS:Medical records of patients with hip fracture ICD-9 CODE (femoral neck fracture and intertrochanteric fracture) admitted from July 2008 to June 2013 were col ected at the Changning District Public Health Information Center and Shanghai Shen Kang Medical Al iance Center. Population distributions of Changning District in 2010 and 2011 were provided by the Disease Control Center of Changning District. Then, the crude morbidity of hip fracture was calculated in terms of different ages and genders. For patients aged over 50 years, every 5 years served as an age group. RESULTS AND CONCLUSION:The incidence rate of hip fractures in the population aged over 50 years was 197.04/100 000, 88.51/100 000 in male and 304.73/100 000 in female. The annual standardized incidence rate of hip fracture was higher in female than male (P<0.05). The crude incidence rate of hip fracture was increased dramatical y in the population over 70 years, especial y in females. It indicates that the incidence rate of hip fractures is closed related to age, gender and osteoporosis.

Objective To evaluate the effects of Janus kinase 2/signal transducers and activators of transcription 3 (JAK2/STAT3) signaling pathway on the brain injury induced by myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Pathogen-free male Sprague-Dawley rats,weighing 200-220 g,were used in this study.Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose level ≥ 16.7 mmol/L 3 days later.Twenty-four rats with diabetes mellitus were randomly allocated into 3 groups (n =8 each) using a random number table:sham operation group (group S),I/R group,and myocardial I/R + AG490 (JAK inhibitor) group (group ⅠA).Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery for 30 min,followed by 120 min of reperfusion in the rats anesthetized with pentobarbital sodium.AG490 3 mg/kg was injected intravenously at 20 min before reperfusion in group IA.The rats were sacrificed at 120 min of reperfusion,and the brains were removed for determination of caspase-3 and nuclear factor kappa B (NF-κB) activities (using colorimetric method),cell apoptosis (by TUNEL),and expression of interleukin-1 (IL-1),IL-6,IL-8,Bax,Bcl-2,cytochrome C (Cyt c),phosphorylated JAK2 (p-JAK2),and phosphorylated STAT3 (p-STAT3) (by Western blot).Apoptosis index was calculated.Results Compared with group S,the expression of Bax,Cyt c,IL-1,IL-6,IL-8,p-JAK2 and p-STAT3 was significantly up-regulated,the expression of Bcl-2 was down-regulated,and NF-κB and caspase-3 activities and apoptosis index were increased in I/R and IA groups (P＜0.05).Compared with group I/R,the expression of Bax,Cyt c,IL-1,IL-6,IL-8,p-JAK2 and p-STAT3 was significantly down-regulated,the expression of Bcl-2 was up-regulated,and NF-κB and caspase-3 activities and apoptosis index were decreased in group IA (P＜0.05).Conclusion Inflammatory responses mediated by JAK2/STAT3 signaling pathway are involved in the brain injury induced by myocardial I/R in diabetic rats.