Atrial Flutter ; diagnosis ; etiology ; therapy ; Electrocardiography ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Treatment Outcome

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective:Investigating the expression of HIV-1 co-receptors CXCR4,CCR5 and chemoking SDF-1 in human placentae and trophoblasts is to explore the mechanism of in-utero transmission of human immunodeficiency virus type 1(HIV-1).Methods:Using semi-quantitative reverse transcriptase-polymerase chain reaction,detected the transcripts of CXCR4,CCR5 in placenta tissues and trophoblasts.Immunocytochemistry and immunohistochemistry analysis revealed the expression of CXCR4,CCR5 in primary cultured first trimester trophoblasts and villous tissue.Also the expression of SDF-1 in villi of first trimester,and the presence of SDF-1 in the culture of isolated trophoblasts were examined by in situ hybridization,immunohistochemistry and enzyme-linked immunosorbent assay.Results:CXCR4 and CCR5 mRNA were detected in placentae of various gestational phases and in first trimester trophoblasts.However,primary cultured trophoblasts were found to be reactive only with antibodies against CXCR4.In the villous tissue sections,CXCR4 was found in trophoblasts,while CCR5 in stromal cell and/or Hofbauer cell.First trimester trophoblasts expressed SDF-1 strongly and secreted SDF-1 in vitro.Conclusion:CXCR4 and CCR5 were expressed in placentae.Hence,they maybe involved in in-utero transmission of HIV-1 as co-receptors.However,SDF-1 expressed in trophoblasts may protect fetus from being invaded by X4-HIV-1.R5-HIV-1 may infect CCR5+ stromal cells and/or Hofbauer cells through placental disruptions.

OBJECTIVETo explore the clinical anesthesia value of transcutaneous acupoint electrical stimulation (TAES) combined with general intravenous anesthesia in endoscopic bilateral thyroidectomy patients.

METHODSTotally 60 patients who underwent endoscopic bilateral thyroidectomy were equally randomly assigned to 2 groups, the treatment group and the control group, 30 in each group. Patients in the treatment group received TAES combined general intravenous anesthesia, while those in the control group received total intravenous anesthesia. Anesthesia was maintained by target controlled infusion of propofolum combined constant speed infusion of remifentanil in the two groups. TAES was maintained from 30 min before anesthesia induction to the end of endoscopic thyroidectomy at bilateral Hegu (L14) and Neiguan (PC6). The mean artery pressure (MAP) and heart rate (HR) were recorded at different time points of anesthesia, i.e., immediately after entry into the operating room (TO), immediately after intubation (T1), 5 min after intubation (T2), 5 min before incision (T3), 5 min after incision (T4), 30 min after inflation (T5), at the end of surgery (T6), 5 min before extubation (T7), immediately after extubation 0 (T8), and 5 min after extubation (T9). The concentration of IL-6 and TNF-alpha were measured at TO, T3, T5, and T6. The target concentration of propofol was also recorded at T3, T4, and T5.

RESULTSThere was no statistical difference in the operation time between the two groups (P >0.05). Compared with TO in the same group, HR at T3-T4 decreased and increased at T8-T9, and MAP increased at T7-T9 in the treatment group; HR decreased at T3 and increased at T7-T9, MAP increased at T1, T5, T7-T9, and MAP decreased at T2-T3 in the control group. IL-6 increased at T5-T6, while TNF-alpha decreased at T6 in the two groups (P <0.01,P <0.05). Compared with the control group at the same time point, HR decreased at T6-T9, MAP decreased at T1, T4, T5, T7-T9, MAP increased at T3, and IL-6 decreased at T5-T6 in the treatment group (P <0. 05). The concentration and the total amount of propofol were significantly lower in the treatment group than in the control group (P <0.01,P <0.05).

CONCLUSIONSTAES could maintain the hemodynamics more stably and inhibit the stress response in endoscopic thyroidectomy. It also reduce the dosage of anesthetics and improve the safety of anesthesia.

Acupuncture Points ; Anesthesia, General ; Anesthesia, Intravenous ; Electric Stimulation ; methods ; Endoscopy ; methods ; Heart Rate ; Hemodynamics ; Humans ; Interleukin-6 ; Piperidines ; Propofol ; Thyroidectomy ; methods ; Transcutaneous Electric Nerve Stimulation ; Tumor Necrosis Factor-alpha

Objective To analyze the clinical characteristics,pathological classification and therapy strategy of rectal carcinoid and its prognostic factors.Methods Forty four patients with rectal carcinoid were diagnosed and treated in Ruijin Hospital Shanghai Jiaotong University from January 2006 to November 2013,among whom 21 patients (19 males and 2 females) were followed-up for 1-7.5 years.The clinical data of these cases were retrospectively analyzed.Results The patients underwent colonoscopy because of changed bowel habits and/or abnormal digital rectal examination,none of them had carcinoid syndrome.Colonoscopy showed that most lesions presented yellowish in color and smooth in surface; the diameter of the tumor was ≤ 1.0 cm in 12 cases (57％) ; the tumors were located at the rectum within 8 cm from anal rim in 17cases (76％); most of them were well differentiated.Immunohistochemistry demonstrated that NSE expression was highly positive.The 1 year-and 3year-survival rate were both 100％.Among 8 cases who were followed up for over 5 year,2 relapsed.Conclusions The digital rectal examination plays a key role in detecting rectal carcinoid.Though prognosis is relatively good,we should keep close following-up to detect the recurrence.The main risk factors influencing the prognosis are tumor size,depth of invasion and clinical stage.The combination measurement of CEA,TSGF,CA19-9 and NSE will either increase the sensitivity or the specificity of early detection.

Background:Inflammatory bowel disease( IBD)is a group of chronic and non-specific intestinal inflammatory diseases of undetermined origin. Functional impairment of macrophages has been associated with the dysregulation of mucosal immunity in intestinal tract of patients with IBD. Aims:To investigate the correlation of serum levels of macrophage polarization-related cytokines with the development and disease activity of IBD. Methods:A total of 105 IBD patients admitted from May 2013 to May 2014 at Shanghai Ruijin Hospital were recruited,of them 65 were Crohn’s disease (CD)and 40 were ulcerative colitis( UC). Twenty-four patients with colonic polyps were served as controls. Serum samples were obtained and the levels of interleukin-1beta(IL-1β),IL-6,IL-10,IL-13,interferon-gamma(IFN-γ)and inducible nitric oxide synthase(iNOS)were determined by ELISA method. Results:Serum levels of IL-1β,IL-6,IL-10, IL-13 and IFN-γ were significantly higher in CD group than in control group(P < 0. 05),and serum levels of IL-10,IL-13 and IFN-γ were significantly higher in UC group than in control group(P < 0. 05). Logistic regression analysis revealed that serum IL-13(OR = 1. 009,P = 0. 005)and iNOS( OR = 0. 982,P = 0. 013)were correlated with CD,while Spearman correlation coefficient demonstrated a link between serum IL-10 and disease activity of CD(rs = - 0. 432,P =0. 014). No correlations were observed between serum levels of these cytokines and development and disease activity of UC (P > 0. 05). Conclusions:Serum levels of macrophage polarization-related cytokines increase to varying degrees in IBD patients,but these cytokines have no obvious correlations with IBD and its disease activity. Presumably,theses cytokines are only involved in but not the triggers in the development of IBD.

This article reviewed pharmacological study development of Punica granatum L. both at home and abroad in recent years. P. granatum has a long medical usage history. Different parts of P. granatum have wide applications in both traditional Chinese medicine (TCM) and other ethnic medicine. Its main chemical compositions were tannins, flavonoids, alkaloids and organic acids. It has obvious pharmacological activities. In recent years, the pharmacological research progress on P. granatum in terms of antibacterial, antiviral, hypoglycemic, antitumor, adjusting blood lipids, antioxidant, and immunoregulation has rapid development. The scientific collection and analysis on effects and new pharmacological research results of P. granatum are hoped to provide references for the study, clinical application, development and utilization of P. granatum and its products.

Adolescent ; Child ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Killer Cells, Natural ; pathology ; Leukocyte Common Antigens ; analysis ; Lymphoma, T-Cell ; genetics ; immunology ; Male ; Microtubule-Associated Proteins ; genetics

OBJECTIVETo explore pathogenesis of post-transplantation diabetes mellitus (PTDM) in renal transplantation recipients.

METHODSA total of 40 renal transplantation recipients were divided into three groups based on oral glucose tolerance test results: normal glucose tolerance (NGT) group (n = 10), impaired fasting glycaemia + impaired glucose tolerance (IFG + IGT) group (n = 16), and PTDM group (n = 14). Insulin resistance (IR) and beta cell function were assessed by homeostasis model.

RESULTSThe differences of the immunosuppressive agents used in these groups were not statistically significant (P > 0.05). Compared with NGT group, insulin area under curve and homeostasis model assessment-insulin resistance index were significantly higher in IGT + IFG group and PTDM group (P < 0.05). Compared with NGT group and IGT + IPG group, insulin secretion index at 30 min and homeostasis model assessment-insulin secretion index were significantly lower in PTDM group (P < 0.05).

CONCLUSIONInsulin resistance and beta-cell dysfunction may play a key role in the pathogenesis of PTDM.

Adult ; Diabetes Mellitus ; etiology ; physiopathology ; Female ; Humans ; Insulin Resistance ; Insulin-Secreting Cells ; physiology ; Kidney Transplantation ; Male ; Middle Aged ; Postoperative Complications ; etiology ; physiopathology ; Retrospective Studies ; Young Adult

OBJECTIVETo identify the risk factors of cardiovascular diseases and cerebrovascular diseases (CVD) events in kidney allograft recipients.

METHODSWe followed up 361 renal transplant recipients who had undergone renal transplantation in our center from January 2000 to December 2003 and evaluated the cumulative incidences and mortalities of CVD complications at baseline and post-transplantation 1, 3, 6, 12, 24, 36, 48, and 60 months. Kaplan-Meier plot was used to assess the incidence and Cox's proportional hazards model to determine the risk factors for cardiovascular complications.

RESULTSThe cumulative incidences of CVD were 3.1%, 5.4%, 9.9%, 13.0%, 18.0%, 21.1%, and 24.1%, 1, 6, 12, 36, 48, and 60 months after transplantation, respectively. History of diabetes mellitus (RR 2.19, 95% CI 1.32-3.97, P = 0.009) and CVD (RR 6.34, 95% CI 3.76-14.60, P = 0.002) as well as the post-transplantation hypertension (RR 1.18, 95% CI 1.02-1.34, P = 0.04), diabetes mellitus (RR 2.82, 95% CI 1.33-7.26, P = 0.002), hyperlipidemia (RR 2.04, 95% CI 1.26-5.17, P = 0.008) and abnormal creatinine (> 200 micromol/L, RR 1.81, 95% CI 1.08-3.21, P = 0.03), and proteinuria (> 0.3 g/d , RR 1.56, 95% CI 1.12-3.54, P = 0.05) were independently correlated with the development of cardiovascular events.

CONCLUSIONHistory of diabetes mellitus and CVD, post-transplant hypertension, diabetes mellitus, hyperlipidemia, abnormal creatinine and proteinuria are the independent risk factors of the development of CVD events.

Adolescent ; Adult ; Cardiovascular Diseases ; etiology ; Female ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Risk Factors ; Young Adult