ObjectiveTo observe the protective effect of high-dosage methylprednisolone (MP) after lumbar spinal stenosis operation. Methods20 Patients with lumbar spinal stenosis accepted laminectomy. The treatment group (11 cases) received MP 30 mg/kg when the skin incised, and followed with MP 40 mg twice a day for 3 d after operation. The control group (9 cases) received MP 40 mg twice a day for 3 d after operation. They were assessed with JOA scale before and after operation. ResultsThe JOA score was (9.25±2.12) and (9.53±2.10) in treatment group and control group before operation (P>0.05), and was (13.43±2.01) and (11.21±2.13) 1 week after operation (P<0.05), (14.62±2.15) and (13.04±2.11) 3 months after operation (P<0.05). The neurological symptom deteriorated in 1 cases of control group. No peptic ulcer, poor wound healing or other associated complications has been found. ConclusionHigh-dosage methylprednisolone may protect the spine cord intraoperative the lumbar spinal stenosis.

Background The circulating endothelial progenitor cells (EPCs)play an important role in postnatal vasculogenesis and restoration of endothelial injury.Previous investigation illustrated that a reduced ocular blood flow and vascular dysfunction caused by endothelial dysfunction plays a role in the pathogenesis of glaucoma.However,endothelial system accommodation is accomplished with the circulating EPCs.Objective The present trail was to investigate EPCs change in patients with primary acute angle-closure glaucoma (PACG)and explore the role of EPCs in the pathogenesis of PACG. MethodsA prospective cohort study was designed.Thirty patients with PACG were enrolled in Tianjin Medical University General Hospital as PACG group,and 20 normal subjects served as control group.Periphery bloodsamples were obtained fromall the patients and thenstained with saturating concentrations of monoclonal antibodies,FITC-conjugated anti-CD34 and CD133 mAb.EPCs identified by CD34,CD133 were enumerated by flow cytometry,and the correlation between EPCs change and its relative factors was analyzed.Informed consent was obtained from each subject before any medical procedure. Results No significant differences were found in age,gender,vascular-related risk factor,blood biochemical indicators between PACG group and normal contol group(P＞0.05 ),but a higher intraocular pressure( IOP)was displayed in PACG group compared with normal control group ( P =0.00 ).The numbers of EPCs were ( 48 ± 22 ) cells/ml in PACG group and ( 65 ± 20 )cells/ml in normal control group with a significant difference between them (P=0.004).In PACG group,the numbers of EPCs were(60± 19 )cells/ml and (34 ±7 )cells/ml respeetively in phase 1 and phase 3 of optical nerve damage (Z=-3.015,P=0.002 ).There was a negative correlation between EPCs numbers and baseline IOP within a certain range( r=-0.835,P＜0.05 ).However,no obvious correlations were seen between EPCs numbers and blood lipid Level,blood glucose level or glaucoma course ( r =0.343,P =0.227 ; r =-0.203,P =0.419 ; r =0.198,P =0.610 ).The EPCs numbers in PACG patients with cardiovascular disease were(56±22)cells/ml and that of without PACG were (35± 15 ) cells/ml( P =0.005 ). ConclusionsThe numbers of EPCs decrease in PACG patient.These results imply that EPCs might play role during the restore of the optical nerve damage in PACG eye.

OBJECTIVETo investigate the salvage therapy for a child with refractory and ( or) repeatedly-relapsed Langerhans cell histiocytosis.

METHODData of a patient with Langerhans cell histiocytosis whose disease relapsed repeatedly treated with cladribine was collected and analyzed and the related literature was reviewed.

RESULTThe initial symptoms developed 3 months after his birth, multiple systems (skin, skeleton, lung, liver) were involved; he was sequentially treated with LCH-III-Group I, JLSG-96, DAL-HX90 chemotherapeutic regimens. The patient got relapses for more than 3 times, but the disease got completely controlled after being treated with cladribine when the patient was 6 years old. The dosage was 10 mg/(m2 · d) for 4 days, and one course lasted for 28 days, the third to fifth courses of treatment used Arac in combination, the whole treating time lasted for 5 months. The patient remained in persistent remission for 8 months since discontinuation of treatment. "Langerhans cell histiocytosis" "refractory" "cladribine" were used as the key words to search in the data bases CNKI, Wanfangdata and Pubmed, 11 articles were picked. According to the literature, the effective rate of cladribine in treatment of repeatedly relapsing Langerhans cell histiocytosis was 44%-100%, with a good response of 22%-86%, the dose was 5-13 mg/(m2 · d). The main side effects were hematological system damages and infection.

CONCLUSIONThe effect of commonly used chemotherapeutic regimens is limited for children with refractory and (or) repeatedly-relapsed Langerhans cell histiocytosis and cladribine can be used as an alternative therapeutic option of the salvage therapy.

Child ; Cladribine ; therapeutic use ; Histiocytosis, Langerhans-Cell ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Recurrence ; Skin

Objective To investigate the appropriate cross-matching methods for the direct antiglobulin test (DAT)positive patients.Methods The DAT was used to screen the irregular antibodies on the surface of erythrocytes.The microcolumn gel test was used for blood identification.The antiglobulin test and manual polybrene test were used for cross-matching.Re-sults A total of five DAT positive cases were collected in study.The blood groups of each case were detected,including A-DCcEe,O-DCCee,O-DCcee,A-DCCee and A-DCcee.The donor samples with corresponding blood-antigen negative were cho-sen for cross-matching,and the agglutination intensity of each cross-matching tube was weaker than the control.The transfu-sion of washed red blood cells was suggested.Finally,each transfusion was safe and efficient.Conclusion The infusion of the washed red blood cells with corresponding blood-antigen negative could efficiently ensure the safety of blood transfusion.

Adult ; Burns, Chemical ; complications ; Humans ; Male ; Nitriles ; Peripheral Nerve Injuries ; etiology

Objective To study the clinical, laboratory, X-ray and the pathological features of Parkinson disease patients with rheumatoid-like deformities. Methods One patient was described and the relevant English literature in recent 50 years were reviewed. Results Rheumatoid-like deformities in Parkinson disease was mostly observed in women. The ratio between male and female was about 1:5.6. Joint deformities occurred after 7.6 years of Parkinson's disease in average. The manifestations of joints included the flexion of the metacarpophalangeal (MCP) joints, hyperextension of the proximal interphalangeal (PIP) joints, flexion of the distal interphalangeal (DIP) joints, and ulnar deviation of wrists and bilateral feet hallux valgus. Whole-blood analysis, biochemistry profile, erythrocyte sedimentation rate, C -reactive protein were all in normal range. Rheumatoid factor and ANA, anti-ENA profile, AKA, anti-cyclic citrullinated peptide (anti-CCP) antibody and antiperinuclear factor (APF) were all negative. Periarticular erosion was not observed in plaint X -ray films. Synovial pathology showed non -specific infla -mmation without classical syno vial membrane proliferation and pannus formation. NSAIDs and DMARDs were uneffective, but on the contrary, anti -parkinson' s disease therapy could relieve joints symptoms. Conclusion Parkinson disease can be accompanied with rheumatoid-like deformities which may be misdiagnosed as RA and should be differentiated from RA by laboratory, radiographs and synovium pathology examination.

OBJECTIVE: To observe the expression of discs large homolog 4 (DLG4) protein in hippocampus, amygdala and frontal cortex of rats and evaluate postsynaptic density in heroin dependence. METHODS: The rat heroin dependent model was established by increasing intraperitoneal injection of heroin. DLG4 proteins in hippocampus, amygdala and frontal cortex of heroin dependent 9, 18, 36 days rats were detected with immunohistochemical staining and compared with that in the control group. RESULTS: DLG4 proteins in hippocampus, amygdala and frontal cortex were gradually reduced with extension of heroin dependent time. CONCLUSION Heroin dependence can affect postsynaptic density of hippocampus, amygdala and frontal cortex. The changes become more apparent with extension of heroin dependence time.
Amygdala/metabolism* ; Animals ; Disks Large Homolog 4 Protein ; Frontal Lobe/metabolism* ; Heroin/pharmacology* ; Heroin Dependence ; Hippocampus/metabolism* ; Injections, Intraperitoneal ; Intracellular Signaling Peptides and Proteins/metabolism* ; Membrane Proteins/metabolism* ; Rats

Objective To assess the value of procalcitonin(PCT)measurement to differentiate infection from non-infection in critically ill patients requiring long-term immunosuppressive therapy.Methods A prospective study was conducted in patients with underlying diseases requiring corticosteroids or chemotherapy in ICU from January 2008 to December 2009.Patients were divided into the infection group and the non-infection group and their PCT levels were compared.Results A total of 103 patients (65 women)were enrolled in this prospective study[aged(47.9 ± 21.9)years old]with 84 in the infection group and 19 in the non-infection group.The baseline level of PCT was significantly higher in infection than in non-infection patients[2.58(0.08-44.65)pg/L vs 0.62(0.15-6.00)pg/L,P =0.002].Different levels of PCT were manifested in different pathogen groups with 3.41(0.45-44.65)pg/L in bacteria infection,0.99(0.28-6.67)pg/L in fungus infection,0.11(0.08-0.20)pg/L in virus infection group(P =0.018).The AUCROC of PCT was 0.867 for diagnostic bacterial infection.By multivariate analysis,the factors associated with the level of PCT were bacteria infection(OR 5.1,P =0.031)and septic shock(OR 7.5,P =0.027),while the factors not associated with the level of PCT were age,renal function,infection site and prognosis(P ＞ 0.05).Conclusions The level of PCT is increased in the critically ill patients requiring immunosuppressive therapy with infection and it can be used for diagnosis for bacterial infection.

Hip Joint ; Humans ; Ischium/diagnostic imaging* ; Magnetic Resonance Imaging

OBJECTIVETo explore the effect of internal fixation with screw through femoral epiphyseal plate on growth in- hibition via an experimental study.

METHODSForty New Zealand rabbits were randomly divided into 4 groups and 10 rabbits in each group. Epiphyseal plate was injured by penetrating of screws, and the size of damage area was controlled by changing the number of threads. Group A: blank group; group B: injury area accounted for 4% of the epiphyseal plate; group C: injury area accounted for 6%; group D: injury area accounted for 8%. The internal fixation was removed after 2 weeks, and the results were observed with X-ray film for 4 groups to judge the complications such as early closure of epiphyseal.

RESULTSIn each group, there were no statistical differences in the length of the femoral neck, the diameter of femoral neck, the diameter of the femoral head, and the epiphyseal plate closure time. The growth speed of the length and diameter of the femoral neck, as well as the diameter of femoral head, were quicker on the early phase, and the speed was slowest when the epiphyseal plate was being closed.

CONCLUSIONThe injury area of epiphyseal plate under 8% is safe for its growth. Because no evidences demonstrate the growth inhibition of epiphyseal plate, the screws can be used for rabbit epiphyseal plates.

Animals ; Bone Screws ; Female ; Femur Head ; growth & development ; surgery ; Fracture Fixation, Internal ; methods ; Growth Plate ; growth & development ; Magnetic Resonance Imaging ; Male ; Rabbits ; Salter-Harris Fractures