Acupuncture Therapy ; Adult ; Aged ; Fasciitis ; therapy ; Female ; Humans ; Male ; Middle Aged

OBJECTIVE: To study the changes of serum vascular endothelial growth factor (VEGF) and beta 2-microglobulin levels before and after radiotherapy in 58 patients with nasopharyngeal carcinoma (NPC), and to elucidate the clinical significance of VEGF and beta 2-microglobulin test before radiotherapy. METHODS: Serum VEGF level was measured by sandwich ELISA in 58 patients with NPC and 24 healthy individuals, and the serum beta 2-microglobulin was assayed with time-resolved fluoroimmunoassay. RESULTS: The serum VEGF level in patients with NPC was (174.0+/-130.0) ng/L, higher than (134.1+/-66.6) ng/L of the healthy subjects, but the difference was not significant (P>0.05). The serum VEGF level was higher in T4 and IV a patients with NPC. No significant differences in the levels of serum VEGF were found among various N classifications in the patients with NPC. Patients with the serum VEGF level higher than 267.3 ng/L (mean+2 s of the serum VEGF level in the healthy individuals) had a shorter metastasis-free survival time (P<0.05). Although the patients with high beta 2-microglobulin level had a shorter survival time, the difference was not significant. CONCLUSION: The NPC patients with high serum VEGF level have a poor prognosis.

Acute Disease ; Humans ; Male ; Middle Aged ; Thrombocytopenia ; chemically induced ; Tyrosine ; adverse effects ; analogs & derivatives

OBJECTIVE:To investigate the occurrence of ADR induced by over-the-counter(OTC)drug in order to guide the rational use of drugs. METHODS:45 cases of ADR induced by OTC drug were analyzed retrospectively in terms of patient's gen-eral information,allergic history,allergenic drugs,reason for drug use,route of administration,incubation period,days of hospi-talization,clinical manifestation,treatment,outcome,etc. RESULTS:Among 45 patients,there were 14 male and 31 female. The patients were mainly 20-30 year-old(31.1%). Three patients had previous history of allergy(6.7%). Most ADR were induced by oral drugs(82.2%). Reasons for drug use were mainly disease of respiratory system(23 cases,51.1%). The results of causality as-sessment were positive in 3 patients(6.7%),probable in 35(n=77.8%),and possible in 7 patients(15.6%). ADR were mainly induced by non-steroidal anti-inflammatory drugs (NSAIDs,57.8%),Chinese patent medicine (20.0%),drugs for external use (17.8%). The clinical manifestations mainly included exanthematous drug eruption (33.3%),erythama multiforme drug eruption (24.4%),urticarial drug eruption(13.3%). CONCLUSIONS:NSAIDs are the main allergenic drugs,and ADR induced by OTC traditional Chinese medicine can not be ignored. To improve medical knowledge and skills of the public and the scientific use of OTC drug are beneficial to improve the clinical treatment level.

Adult ; Endoscopy ; Epistaxis ; etiology ; surgery ; Female ; Humans ; Middle Aged ; Nasal Cavity ; surgery ; Telangiectasia, Hereditary Hemorrhagic ; complications ; surgery

Objective To investigate the clinical value of fast track surgery (FTS) in donor in liver transplantation.Methods The clinical data of 214 donors for liver transplantation at the Renji Hospital of Shanghai Jiaotong University from January 2006 to November 2011 were retrospectively analyzed.All donors were divided into FTS group and conventional group.From January 2006 to May 2009,73 donors who received conventional perioperative management were in the conventional group,and 141 donors who received FTS from May 2009 to November 2011 were in the FTS group.The recovery of the donors in the 2 groups was compared.All data were analyzed using the chi-square test or t test.Results The operation time,time to out-of-bed activity,time to postoperative exsufflation,time to bowel movement,and duration of postoperative hospital stay were (178 ±37) minutes,(1.6 ± 1.0) days,(2.9 ± 1.6) days,(3.1 ± 1.5) days and (5.9 ± 1.9) days in the FTS group,which were significantly shorter than (167 ± 33) minutes,(3.6 ± 1.4) days,(4.6 ± 2.3) days,(4.5 ± 1.4) days and (7.6 ± 1.5) days in the conventional group (t =2.115,77.138,6.504,6.913,6.970,P ＜ 0.05).The hospital costs of the FTS group and the conventional group were (1.8 ±0.6) × 104 yuan and (2.2 ±0.4) x 104 yuan,respectively,with a significant difference between the 2 groups (t =73.038,P ＜ 0.05).The volumes of operative blood loss of the FTS group and the conventional group were (130 ± 47)ml and (138 ± 46)ml,with no significant difference between the 2 groups (t =1.251,P ＞ 0.05).The rate of satisfaction of the donors in the FTS group and conventional group were 98.6％ (139/141) and 89.2％ (74/83),respectively,with a significant difference between the 2 groups (x2 =9.94,P ＜ 0.05).Conclusion FTS is safe,economical and can reduce stress,decrease hospital costs and promote early recovery of donors in liver transplantation.

Objective: To investigate the effects of electroacupuncture (EA) on the behaviors of rat with anxiety disorder, and the expressions of hippocampal neurotransmitters including 5-hydroxytryptamine (5-HT), norepinephrine (NE) and dopamine (DA), and the expressions of hippocampal B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X (Bax).Methods: Forty-six male Wistar rats were randomly divided into a control group (n=10), a model group (n=12), an EA group (n=12), and a drug group (n=12). Except the control group, the other three groups were established into rat models of anxiety disorder using uncertain empty bottle stimulation. Rats in the EA group and the drug group received corresponding interventions for 15 consecutive days [EA group was given EA at Baihui (GV 20) and Sanyinjiao (SP 6); the drug group was given aqueous solution of alprazolam via intragastric administration]. After intervention, all four groups received open-field test (OFT) and elevated plus-maze (EPM) for behavioral evaluations. The expressions of 5-HT, NE and DA in hippocampus were determined by fluorescence spectroscopy (FS) while the expressions of Bcl-2 and Bax proteins in hippocampus were determined by Western blot (WB). Results: The OFT horizontal scores in the control group, EA group and drug group were significantly higher than that in the model group (all P<0.05), and the difference between the EA group and the drug group was statistically insignificant (P>0.05); the OFT vertical scores in the model group, EA group and drug group were significantly lower than the score in the control group (all P<0.05). The EPM percent of open-arm entries (OE％) in the control group, EA group and drug group was higher than that in the model group (P<0.05), and the differences among these three groups were statistically insignificant (P>0.05); though the percent of open-arm total time (OT％) in the EA group was lower than that in the control group (P<0.05), the difference was statistically insignificant when compared with the drug group (P>0.05), and it was significantly higher than that in the model group (P<0.05). The expression of 5-HT in the EA group was higher than that in the control group (P<0.05); the expression of 5-HT in the EA group was significantly lower than that in the model group (P<0.05); the difference between the EA group and the drug group was statistically insignificantly (P>0.05). The expression of NE in the model group was significantly higher than that in the other three groups (P<0.05), and there was no significant difference among these three groups (P>0.05). The expression of DA in the EA group was significantly higher than that in the control group and the drug group (both P<0.05), while the difference between the EA group and the model group was statistically insignificant (P>0.05). The expression of Bax in the model group was significantly higher than that in the other three groups (all P<0.05), whereas the expression of Bcl-2 in the model group was significantly lower than that in the other three groups (all P<0.05), and the differences in both Bax and Bcl-2 among the other three groups were statistically insignificant (all P>0.05). Bax/Bcl-2 in the EA group was significantly higher than that in the control group (P<0.05) and lower than that in the model group (P<0.05), and the difference was statistically insignificant when compared with the drug group (P>0.05). Conclusion: EA shows promising effects in attenuating rats' anxiety disorder, which may be achieved by the down-regulation of the expressions of 5-HT and NE in the hippocampus and/or inhibition of hippocampal neuronal apoptosis. The efficacy is comparable to that of intervention with alprazolam.

Objective To compare MR,CT,and radiography in the detection of arthropathies in patients with hemophilia.Methods Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years,were used in this study.Each joint had the examinations of radiography,CT and MR within one day.The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study.Imaging findings of soft tissue swelling, osteoporosis,epiphyseal overgrowth,joint erosion,cyst,joint space narrowing,bone marrow,joint effusion, hemorrhage,synovial hypertrophy,widened intercondylar notch as well as anterior and posterior crueiate ligaments(only for knee joint)were used for the all imaging comparison.Results The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0(n=5),stage 1(n=7),stage 2(n=6),stage 3(n=8)and stage 4(n=15).Soft tissue swelling or joint effusion was observed in 33 joints by radiographs,in 34 joints by both CT and MR.Joint erosions were demonstrated in 34 joints by MR,in 33 joints by CT and 20 joints by radiographs.Joint cysts were shown in 21 joints by MR,in 18 joints by CT and 9 joints by radiographs.Significant differences in detection of erosion and cyst were found between radiography with either CT(P0.05).MR showed improvement for detecting nlore loci of both erosion and cyst than CT and radiography,and also CT showed the improvement than radiography.Bone marrow edema 14 joints, hemon'hage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images.Conclusion MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modafities in evaluating hemophilic arthropathies.

Objective To clarify the role of the virtual reality (VR)in the training of trans-femoral cerebral angiography for novices without any experience of intravascular manipulation. Methods Twenty-four novices without experiences of intravascular manipulation were divided into 2 groups (VR group or control group)with random pair method concerning the age,gender and subjects. The par-ticipants in control group were trained in routine manners while those in VR group practiced on a simulator and subsequently participated in real angiography once as assistants. Real angiography tests were performed for all participants after the training session and additional angiography tests were per-formed for VR group just after the stimulation session on the simulator. Real angiography tests were supervised and scored according to a modified rating scale by neuroradiological experts who were blinded to the novices' training procedures. Difference between the real test performance of the two groups were compared by pared-samples t test,while the correlation between the performance of the real tests and simulator tests of VR group was proved by Pearson correlation analysis. P<0.05 was con-sidered statistically significant. Results The mean scores of VR group were (27.6±3.6)and (26.4± 3.8)in the tests on simulator and real angiography tests respectively,while score of control group was (21.2±3.4)in the real angiography tests. A positive correlation was revealed in VR group between performance on the simulator and that on real patients (r=0.825,P=0.001). Real performance of the VR group was significantly better than that of control group (P=0.010). Conclusions Virtual reality could ensure transfer of acquired endovascular skills from simulators to patients so as to become a valid tool for novices to improve the interventional techniques in tranfemoral cerebral angiography.

Objective To preliminarily discuss the efficacy and safety of balloon protection technique in venous sinus in the embolization of lateral sinus dural arteriovenous fistula.Methods FromDecember 2012 to August 2016,7 consecutive patients with lateral sinus dural arteriovenous fistula embolized with Onyx under the protection of venous sinus balloon were enrolled retrospectively. Their clinical data,imaging data,and follow-up results were analyzed.Results In 7 patients,the fistulas of 3 cases were located in the sigmoid sinus and the fistulas of 4 cases were located in the transverse sinus. Immediately after operation, 5 patients were embolized completely and 2 were embolized mostly. All balloon protected venous sinuses maintained patency. Seven patients were followed up clinically and the follow-up time was 6-43 months. No new neurological deficits were observed. All 7 patients received whole DSA reexamination and the follow-up time was 6-11 months. It is suggested that 5 patients were completely cured,among them,the venous sinuses were patent in 4 cases,the venous sinus was occluded in 1 case;the fistula was stable and venous sinus patency in 1 case;and 1 had newly complicated venous sinus occlusion.Conclusion At the same time of embolization of the fistulas,the dural arteriovenous fistulas were embolized under the protection of venous sinus balloon. It could maintain long-term patency of venous sinus and be conductive to maintaining the stability of the embolization effect.