OBJECTIVETo investigate a manipulating therapy for treatment of anterior shoulder dislocation in elderly.

METHODSFrom October 2011 to June 2012,27 elderly patients with anterior shoulder dislocation were treated by extorsion traction and pushing manipulation with fingers, including 7 males and 20 females aged from 65 to 86 years old with an average of 77. The course of disease ranged from 1 h to 1 d. The shoulder manifested square deformity, Dugus signs showed positive, and X-ray displayed anterior shoulder dislocation. Dugus fixation was applied for and removed external fixation at 3 weeks after operation and carried out shoulder functional exercise. Functional evaluation standard on shoulder joint injuries was used for evaluate clinical outcomes.

RESULTSAll patients were gained reduction for the first time, and followed up at 3 months after operation, no dislocation occurred. According to functional evaluation standard on shoulder joint injuries, 22 cases got an excellent result,2 cases good,and 1 case moderate.

CONCLUSIONExtorsion traction and pushing manipulating therapy for treatment of anterior shoulder dislocation in elderly, which has advantages of simple, convenient, less painful, and can avoid iatrogenic injury, is feasible to widespread.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Shoulder Dislocation ; physiopathology ; therapy ; Shoulder Joint ; physiopathology ; Traction ; Treatment Outcome

Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.

Objective By means of value-added reflection of students' learning behavior, this article gives an objective description of the current situation of pharmaceutical undergraduate education and puts forward some suggestions to strengthen the connotation construction of pharmaceutical education.Method Using the Chinese College Student Survey (CCSS) developed by Tsinghua University and Indiana University (US), 1100 students participated in a one-to-one web-based anonymous questionnaire, and using SPSS19.0 to analyze the data.Five comparable indexes and students' recognition behaviors were discussed using descriptive analysis and independent sample t test.Result The five comparable index scores and learning behavior skill index scores of the students in Chinese traditional medicine specialty and pharmacy were higher than the national overall level of all kinds of colleges and universities of science categories.Compared with the national norm of medical colleges, except that the score of 43.36 of the five comparable indexes in pharmaceutical professional academic challenge (level of academic challenge, LAC) was less than 43.63 national medical colleges LAC norm level, the other index scores were higher.LAC and active collaborative learning scores of Chinese pharmaceutical majors were lower than those of pharmacy students, and the difference was statistically significant (P＜0.05).In the study of behavioral skills, the scores of two major students' use, evaluation and comprehensive behavior were lower than the national standard of medical institutions, and there was a statistically significant difference in the scores of Chinese medicine and pharmaceutical majors (P＜ 0.05).Conclusion Teaching experience and learning support need to be optimized for pharmaceutical students.Learning scientificalness and comprehensive abilities in pharmaceutical education need to be improved.Mid and higher level of learning behavior needs to be enhanced for pharmaceutical students.

Objective To investigate the clinical manifestation of bacterial urinary tract infections among old patients with diabetes in recent seven years.Methods In this retrospective study,contrast analysis of clinical features was per- formed on urinary tract infections in old patients between 56 cases with diabetes and 56 cases without it diagnosed during 1998 to 2005.measuring fasting blood glucose,2 hour blood glucose,plasma albumin,24-hour microalbuminuria. Results Incidences of diabetic nephropathy,diabetic retinopathy,neuropathic bladder in observed group are signifi- cantly higher than control group.FBG、2hPBG、24-hour microalbuminuria are significantly higher than control group and plasma albumin is lower than control group.Conclusion The urinary tract infection in old patients with diabetes is associated with fasting blood glucose concentration,complication,gender,disease period and ages,etc.

Recent studies have confirmed that both CD40 molecule and its ligand CD40L played important roles in various stages of atherosclerosis.The critical cell component of atherosclerosis- endothelial cells,macrophages,and smooth muscle cells on which there are expressions of CD40 and CD40L.The combination of both induces human vascular endothelial cells expressing various active media,participating in the formation of atherosclerosis.However,blocking the CD40-CD40L pathway can prevent atherosclerosis or prevent the plaques from progressing.CD40L may participate in thrombosis and activation of platelet.The soluble CD40L levels increase persistently in patients with acute cerebral infarction and acute coronary syndrome.Some drugs may down-regulate CD40L level.It has provided a new approach for preventing the occurrence of vascular events.

Background and purpose:Drug-resistance is the main obstacle in terms of efficacy of chemotherapy for leukemia, RNA interference(RNAi) strategy possesses the characteristics of specilization, high-efficiency and low-toxicity, and can effectively and specifically inhibit the overexpression of given gene. This study was designed to investigate the effect of small interfering RNA (siRNA) on expression of mdr1 gene and drug-resistance in multidrug-resistant human leukemia K562/ADM cell.Methods:Human multidrug-resistant leukemia cell line K562/ADM over-expressing mdr1 gene was used as the target cells, Two siRNAs (si-mdr1-1 and si-mdr1-2) targeted mdr1 gene were chemically synthesized and transfected into K562/ADM cells. Expression of mdr1 mRNA was determined by RT-PCR, P-glycoprotein (P-gp) expression was measured using flow cytometry (FCM), and the sensitivity of K562/ADM cells to adriamycin was assessed with a MTT colorimetric assay.Results:Two siRNAs (si-mdr1-1 and si-mdr1-2) specially designed in this study could markedly down-regulate the expression of mdr1 mRNA and its product P-gp in K562/ADM cells. After cells transfected with si-mdr1-1 or si-mdr1-2 for 24h and 48h, the inhibition of mdr1 mRNA expression in the cells for si-mdr1-1 was 55.5% and 22.5%; and for si-mdr1-2, 16.0% and 57.6%, respectively. Treated with siRNA for 72h, the expression intensity of P-gp in the two transfected cell lines decreased 74% and 85%, respectively. Both si-mdr1-1 and si-mdr1-2 significantly enhanced the sensitivity of K562/ADM cells to adriamycin and reversed their drug-resistance, the reversal efficiency was 2.52-folds and 1.96-folds, respectively.Conclusions:The siRNA could effectively and specifically silence the expression of mdr1 gene and overcome the drug-resistance mediated by P-gp in K562/ADM cells.

Objective To explore the therapeutic effect and safety of high-frequency diathermic therapy combined with oral S-1 and intraperitoneal perfusion chemotherapy on malignant seroperitoneum of advanced gastric carcinoma.Methods Fifty-two advanced gastric carcinoma patients with malignant seroperitoneum were divided into observation group and control group.Twenty-five patients in observation group were received DDP 60 mg/m2 combined with 5-Fu 600 mg/m2 and IL-2 3 000 000 U intraperitoneal perfusion chemotherapy,as well as oral S-1 of 40mg bid on day 1-14 of every 21 days for a total of two or three cycles.High-frequency diathermic therapy was administered thirty minutes after intraperitoneal perfusion chemotherapy,twice a week for 3 weeks.Twenty-seven patients in control group were treated with S-1 and intraperitoneal perfusion chemotherapy only.Results In observation group,4 patients were CR,15 patients were PR,5 patients were SD,1 patient was PD,and the response rate (CR+PR) was 76 ％.In control group,3 patients were CR,14 patients were PR,7 patients were SD,3 patients were PD,and the response rate (CR+ PR) was 63 ％ (P ＞ 0.05).Median survial time for observation group was 10.0 months,8.0 months for control group (P ＞ 0.05).Karnofsky scores after treatment in observation group was higher than that in control group,patients' clinical benefit rate were 80.0 ％ (20/25) and 51.9 ％ (14/27).The difference in life quality between the two groups was statistically significant (P ＜ 0.05).There was no significant difference in adverse reactions between the two groups (x2 =4.544,P =0.033).Conclusion High-frequency diathermic therapy combined with oral S-1 and intraperitoneal perfusion chemotherapy for advanced gastric carcinoma with malignant seroperitoneum has good short-term curative effects and security,and this method should be further studied.

Facing current situation of integrative medicine (IM), authors put forward that clinical and diagnosis program of IM could be carried out from clinical path, pathogenesis, treatment theory and philosophy, and so on, but with different integration degrees. Meanwhile, formulation of concrete program should be disease-targetedly set up, and adjusted from person to person, from place to place, from time to time. As for settled IM program , authors could evaluate it from whether Chinese medicine and Western medicine have formed complementary, synergistic, excitatory actions, and toxicity attenuation; whether more problems could be solved in efficacy, safety, practicability, and economy than previous single mode.
Critical Pathways ; Integrative Medicine ; trends ; Medicine, Chinese Traditional ; trends

Co-processed excipients withgelatinized or non-gelatinized starch were prepared by spray drying. Powder and tablet properties of corocessed excipients prepared were compared with those of physical mixtures and spray-dried lactose. Their applicability in traditional Chinese medicine (TCM) powder tableting was tested on two TCM extracts, i.e., the gardenia extract and the Herba Sedi extract. It was shown that gelatinizing starch before co-spray drying with lactose could improve the performance and efficiency of starch as a binder, resulting in remarkable improvement in physicomechanical properties of co-processed excipients prepared. Conpared to self-made and commercially available spray-dried lactose, co-processed excipients achieved better compactability and higher drug loading for TCM extracts. In conclusion, the lactose-gelatinized starch co-processed excipient, with excellent physicomechanical properties, is promising to be explored as a new excipient for direct tableting.
Excipients ; chemistry ; Lactose ; chemistry ; Medicine, Chinese Traditional ; methods ; Powders ; chemistry ; Starch ; chemistry ; Tablets ; chemistry

Calcaneus ; diagnostic imaging ; Female ; Humans ; Radiography ; Tuberculosis, Osteoarticular ; diagnosis ; diagnostic imaging ; Young Adult