Objective：To study anatomic basis of ligaments factors in carpal radial instability. Methods:The length, width, thickness and maximum length of radial scaphoid capitate ligament(RSCL) , radial lunate ligament(RLL) , radial scaphoid lunate ligament(RSLL),radial scaphoid ligament(RSL), scaphoid trapezium ligament(STmL), scaphoid lunate interosseous ligament(SLIL), scaphoid triangular ligament(STgL) and radial ulnar triangular ligament(RUTgL)were measured in the neutral position. The length of RSCL, RLL, RSLL, RSL and RUTgL in the maximum position of radial deviation, ulnardeviation, palmarflexes and dorsiflexes were also measured. The normal and maximal distance of scaphoid lunate gap(SLG) , scaphoid trapezium gap(STmG), radial scaphoid gap(RSG) and capitate lunate gap(CLG) were measured,especially for variation of SLG in the condition of different ligament lesions. Results:Volar carpal radial ligaments were thicker than dorsal ones. The injuries of SLIL, STmL, RSL and CLL were considered generally when SLG>4.78±0.54mm, STmG>3.71±0.32mm, RSG>5.77±0.79mm, CLG>4.62±79mm; when SLIL was incised completely, SLG>5mm. Keeping anatomic structure of SLIL and incising other ligaments, there existed no obvious variation in SLG. Keeping dorsal part and incising proximal and palmar ones, no obvious variation of SLG can be observed. Conclusions: There were no effects on SLG when carpal radial ligaments (except dorsal part of SLIL) were injuried .Dorsal part of SLIL played a very important role in keeping SLG normal.

Objective:To investigate the effects of interferon-? on bleomycin-induced pulmonary fibrosis in rats and to study the mechanism of its effects.Methods:60 SD rats were randomly divided into 3 groups of 20:normal control group(Group N), model control group(Group M) and interferon-?(IFN-?)treated group(Group R). The pulmonary fibrosis model was established by a single intratracheal injection of 5 mg/kg of bleomycin. The rats were sacrificed at days 3,7,14,28 after modeling in batch. Lung tissues were restored to analyze the pathological changes, the content of hydroxyproline,mRNA expression of IFN-? and transforming growth factor-?(TGF-?).Results:The scores of alveolitis in Group M and R were higher than that in Group N at each poin-in-time after modeling.The scores of alveolitis in Group R were higher than that in Group M. The scores of pulmonary fibrosis and the content of hydroxyproline in lung tissues in Group M and R were higher than that in Group N at day 14 and 28. The expression of IFN-? mRNA in lung tissues at day 3,7,14,28 and TGF-? mRNA at day 3 in Group R were higher than that in Group M(P

Objective To investigate the diagnosis,treatment and prognosis of bilateral renal clear cell carcinoma in the elderly.Methods Clinical data from 38 cases of elder patients admitted with bilateral renal clear cell carcinoma in our department from 2010 to 2014 were retrospectively analyzed.Among the total 38 cases diagnosed by B ultrasound and CT,13 cases(A group)were treated with laparoscopic radical nephrectomy on one side,combined with microwave ablation on the other side;another 25 cases(B group)were treated with microwave ablation on bilateral sides.Patients were followed up for 24-36 months,with regularly checking by B ultrasound,CT and renal function.Results The operations were successful in total 38 cases (A +-B group),and no postoperative complications were found.All cases were diagnosed as pathologically proven bilateral renal clear cell carcinoma.Postoperative renal functions of the cases were decreased at different degrees as compared with preoperative renal functions,but not needing dialysis treatment.The microwave ablation on bilateral sides(B Group) versus A Group,significantly decreased the surgical time cost (P =0.012) and hospital stay(P =0.021).For both A and B group,postoperative renal function were declined in different degree.The damage extents of blood urea nitrogen,creatinine and creatinine clearance rate were less in group B than in group A at one week after surgery(P=0.008,0.009 and 0.006).Atpostoperative follow-up for 3 month,it was found that the damage extents of blood urea nitrogen,creatinine and creatinine clearance rate were less in group B than in group A (P =0.037,0.020 and 0.018).At postoperative follow-up for 30 months in average,no local recurrence or metastasis was found.Diagnosis of bilateral kidney clear cell carcinoma in the elderly mainly depended on B ultrasound,CT scan and MRI imaging.Conclusions As to the treatment of elderly patients with early renal clear cell carcinoma,considering both the general healthy condition of patients and tumor therapy and choosing microwave ablation might be good for efficiency and prognoses.

Objective To investigate the efficacy and safety of perioperative use of different hemostatic drugs in elderly patients undergoing transurethral resection of the prostate (TURP).Methods A total of 480 elderly patients with benign prostatic hyperplasia (BPH) admitted to the Departments of Urology and Gerontology of our hospital from January 2010 to October 2014 were selected and randomly divided into 6 groups (n =80,each).Patients in all groups were given preoperative oral finasteride for 1 week,with each of the non-control groups receiving perioperative heamocoagulase agkistrodon,mangabeys hemocoagulase,reptilase,ethylenediamine diaceturate,or dicynone + paraaminomethyl benzoic acid (PAMBA).Intraoperative bleeding,perioperative hematocrit,hemoglobin change,continuous bladder irrigation time,adverse reactions and other clinical parameters were recorded.Results Operations went smoothly with all patients.Changes in perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time had significant differences between the control group and the groups treated with hemostatic drugs (all P＜0.05).No significant differences in perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time were found between groups treated with heamocoagulase agkistrodon,mangabeys hemocoagulase and reptilase,or between groups treated with ethylenediamine diaceturate and dicynone+PAMBA (all P＞ 0.05).There were significant differences in the perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time between the groups with and without blood coagulation enzymes (all P ＜0.05).Fibrinolytic responses occurred in 2 patients in the heamocoagulase agkistrodon group and were mitigated after drug withdrawal and fibrinogen infusion.Conclusions A reasonable perioperative dose of a hemostatic drug has good clinical effects in elderly patients undergoing TURP.Hemostatic drugs such as blood coagulation enzymes have certain advantages including safety over other types of hemostatic drugs,but their doses should not be too large.

Objective:To study the effects of Anti-DR5 mAb on inducing synovial cells of adjuvant arthritis (AA) rats and its mechanisms.Methods:AA was induced by CFA in rats.The synovial cells of rats were separated and cultured in vitro system.The apoptosis induced by anti-DR5 mAb on synovial cells was measured by MTT analysis,DNA fragmentation and flow cytometry.Caspase-3 and Bcl-2 expression in synovial cells were detected by Western blot.The involvement of the apoptotic pathway was further proved by a caspase inhibition assay.Results:MTT result showed that Anti-DR5 mAb could inhibit synovial cells growth.And flow cytometry suggested that the cell death mode was apoptosis.The protein level of caspase-3 in synovial cells treated with anti-DR5 mAb was raised,while Bcl-2 level declined.When the caspase inhibitor was added to the synovial cells treated with anti-DR5 mAb,it was showed in a dose-dependence inhibition effect,indicating that anti-DR5 mAb inducing apoptosis might be through the caspase pathway.Conclusion:Anti-DR5 mAb could induce synovial cell apoptosis through caspase pathway.And this effect may be related to the protein level of Caspase-3 and Bcl-2.

This paper was aimed to understand the clinical features of traditional Chinese medicine (TCM) through the analysis of relevant information among fracture patients treated by the Cervus and Cucumis Polypeptide Injection (CCPI).The study was conducted among fracture patients treated by CCPI in the hospital information systems (HIS) among 26 national triple-A hospitals from 2003 to 2014.The general information,TCM syndrome and solar term of morbidity were analyzed.The results showed that the number of patients from 45-64 years old were the most,accounting for 39.84％.Among them,the number of male patients from 18-44 years old was the most,accounting for 43.38％;the number of female patients from 45-64 year old was the most,accounting for 44.33％.The main TCM syndrome of admission and discharge was qi stagnation and blood stasis,which accounted for 60.53％ and 53.08％,respectively.Beginning of Summer (7th solar term) and Rain Water (2nd solar term) were solar terms with the most patients,which accounted for 5.26％ and 5.24％,respectively.It was concluded that the majority of fractures patients treated with CCPI were the elderly.The syndrome of qi stagnation and blood stasis was the most.The hospital admission of most patients was at the Beginning of Summer and Rain Water.It provided theoretical basis to pay attention on TCM syndrome differentiation in the treatment of clinical fractures.The treatment should be adapted to the characteristics of the disease itself,the change of solar terms,and dialectical medication.

BACKGROUND:Previous studies have documented that,the increase of anti-cardiolipin(aCL) antibody titer has an obvious positive relaltionship with the vascular thrombosis,thrombocytopenia and repeated abortion in the patients with systemic lupus erythematosus and antiphospholipid syndrome,but there is little information on the aCL antibodies in lupus nephritis(LN).OBJECTIVE:To ascertain the preyalence and significance of aCL antibodies in Chinese patients with LN.DESIGN:Prospective follow-up study of one sample.SETTING:Department of Rheumatology in Xiangmihu Branch of Shenzhen Fourth People's Hospital,Shenzhen Institute of Rheumatology in Guangdong Medical College.PARTlCIPANTS:The study was performed in 97 LN Patients consecutively recruited in the Department of Rheumatology in Xiangmihu Branch of Shenzhen Fourth People's Hospital between March 2001 and October 2003.All the included patients met the revised criteria of American College of Rheumatology for the diagnosis and classification of LN.And they all knew the fact saying yes.METHODS:The clinical data and auxiliary examination result were recorded when hospitalizalion.The aCL antibodies were measured by the enzyme-linked immunosorbent assay,and Were considered as positive if over 100 U/mL.High-dose oral administration of prednisonc combined with cyclophosphamide intravenous pulse therapy were applied for inducing release.The curative effect was remained by using azathioprine and prednisone at a decreasing dose.Meanwhile the complications such as hypertension,hyperlipemia and arthralgia were prevented by drugs.All the patients had routine visits at six-month intervals for a total of 3 years,Clinical and seroIogic manifestations of Patients with LN were tested and recorded regularly.MAIN OUTCOME MEASURES:Gender,age,systemic lupus erythematosus disease activity index,clinical manifestations,vascular thrombosis,pregnancy outcome and renal function.RESULTS:All the 97 LN Patients were included in the study.and 83 of them entered the result analysis while the other 14 cases were lost.The overall prevalence of aCL antibodies in 97 subjects was 39%(38 cases).Hypertension,thrombocytopenia and Raynaud's phenomenon were more frequent in LN Patients with aCL antibodies.The aCL IgG antibody-positive Patients showed a greater risk for the occurrence of vascular thrombosis;Pregnancy morbidity of miscarriages,premature birth,fetal death and the probabmty of developing irreversible renal function deterioration occurred at a greater frequency in aCL antibody-positive patients.CoNCLUSIoN:The prevalence of aCL antibodies in LN Patients is 39%.A higher incidence of hypertension.thrombocytopenia and Raynaud's phenomenon is found in patients with aCL antibodies.Detection of aCL antibodies in Patients with LN may be usefol to predict the development of vascular thrombosis,pregnancy morbidity and irreversible chronic renal function deterioration.

Objective To investigate the clinical and neuroimage characteristics of reversible posterior leukoencephalopathy syndrome (RPLS) in Chinese elderly patients. Methods The characteristic clinical presentation and neuroimaging of 5 elderly patients with RPLS were retrospectively analyzed. Results There were one male and four females in this study, with the average age of (63.0±2.4) years, all combined with hypertension. The most common clinical presentations were abnormality of visual perception (5 cases), headache (4 cases), epileptic seizure (4 cases), disturbance of consciousness (3 cases), pathological reflex (2 cases) and hemiplegia (2 cases). CT scan showed 4 cases with low density lesions. MR1 scan showed 5 cases with occipital lobe lesions, 2 with parietal lobe lesions and 1 with temporal lobe lesions. Re-examination of CT scans showed that 4 survived patients became normal at mean (48.8±29.2) days after discharging from hospital. Conclusions The etiologies of RPLS are diverse. The vasogenic theory is supported by neuroimage of RPLS. Neuroimage may be very important for the diagnosis of RPLS. Diffusion-weighted imaging and apparent diffusion coefficient map may be helpful for differential diagnosis between RPLS and cerebral infarct.

Objective To investigate the age-associated changes of ultrastructure,mRNA and protein expressions of H+-K+-ATPase in elderly gastric parietal cell. Methods Fifty patients with relative normal stomach without gastroduodenal diseases were enrolled,including younger group (aged 20-59 years,n=19) and elderly group (aged≥60 years,n=31).Furthermore,the elderly group was divided into 3 subgroups:60-69 years old (n =11 ),70-79 years old (n=10 ),above 80 years old (n =10).The ultrastructure of gastric parietal cell was observed under electron microscope.The expression of H+-K+-ATPase α subunit mRNA and H+-K+-ATPase β subunit protein were assessed by quantitative real-time PCR and Western-blot,respectively.The ageing-associated changes of all these data were respectively compared. Results No significant difference was showed in the morphology of gastric parietal cell and acid-secretion-associated organelles among all the groups.The average ratio Am to Ac (Am means the area of mitochondria,Ac means the area of cytoplasm) of gastric parietal cell and the average At to Ac ratio (At means the area of secretory canaliculi and tubulovesicular system )between younger group and elderly group had no significant difference[(48.4±7.5) ％ vs.(50.6±7.6) ％,t=-0.775,P=0.444; (13.8±4.1) ％ vs.(12.2±4.7) ％,t=0.984,P=0.332].Meanwhile,there were no distinctions in the expression of H+-K+ -ATPase α subunit mRNA and H+-K+-ATPase protein among all elderly subgroups(F=1.522,2.32,P=0.24,0.114).However,the mRNA expression of H+-K+-ATPase a subunit was higher in the elderly group than in the younger group(t=-3.682,P=0.001).Furthermore,the expression of H+ -K+ -ATPase protein in the elderly group was increased as compared with younger group(t=-3.389,P=0.004). Conclusions Acidsecretion-associated organelles of human gastric parietal cell have no degeneration and the expression of H + -K+-ATPase is in trend of increase with aging,indicating that healthy elderly people have the basis of ultrastructure and molecular biology to maintain well function of acid secretion.

This article elaborates key points of the PACS and RIS project: its overall planning, implementation step by step, integration of PACS and HIS based on IHE, and the prudent selection of partners and so on.
Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Radiology Information Systems ; Software ; Systems Integration