Adolescent ; Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glycyrrhizic Acid ; therapeutic use ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; Male ; Middle Aged ; Phytotherapy ; Salvia miltiorrhiza

OBJECTIVETo observe clinical therapeutic effect of electroacupuncture combined with medicine on acute gouty arthritis and effect on blood uric acid content.

METHODSOne hundred cases of acute gouty arthritis were randomly divided into 3 groups, an electroacupuncture group treated by acupuncture at Zusanli (ST 36), Fenglong (ST 40) and Ashi points, a Western medicine group by oral administration of indometacin and benzbromarone, and a combined electroacupuncture and medicine group by electroacupuncture combined with the Western medicine. The changes of their blood uric acid levels before and after treatment were detected and their therapeutic effects were compared.

RESULTSThere was a significant difference among the three groups in clinical therapeutic effect (P < 0.05), and the effective rate was respectively 97.5%, 90.0% and 86.7% in the combined electroacupuncture and medicine group, the electroacupuncture group and the Western medicine group, the combined electroacupuncture and medicine group being significantly higher than the electroacupuncture group and the Western medicine group; after treatment, the blood uric acid level in all the 3 groups had significant change (P < 0.05), the blood uric acid in the combined electroacupuncture and medicine group had more obvious decrease as compared with those in the electroacupuncture group or the Western medicine group.

CONCLUSIONElectroacupuncture combined with the Western medicine has a definite therapeutic effect on acute gouty arthritis.

Acupuncture Therapy ; Administration, Oral ; Arthritis, Gouty ; therapy ; Combined Modality Therapy ; Electroacupuncture ; Humans

Plants in Ainsliaea genus, belongs to Compositae family, are traditional Chinese medicine and widely used in folk. These plants contain various types of chemical components, and main components are sesquiterpene lactone and its glycosides. In addition, there are triterpenoids, flavonoids, steroids, phenolic acid, long chain fatty acid and volatile oils. Recently, much attention has been payed to varlous research of A. fragrans. This paper reviewed and summarized the chemical components to provide the theoretical basis for the use of Ainsliaea.
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Molecular Structure

OBJECTIVETo investigate the methods and effects of secondary intervention for mid-long term complications of endovascular repair (EVR) in aortic diseases.

METHODSFrom May 1999 to Jun 2007, 21 patients with mid-long term complications after EVR were treated in our center. Of these cases, 15 cases received first EVR for abdominal aortic aneurysm (AAA), 3 cases for thoracic aortic aneurysm (TAA) and 3 cases for aortic dissection (TAD). The mid-long term complications included 11 cases of type I endoleak, 4 cases of type II endoleak, 2 cases of type III endoleak and 4 cases of migration of stent grafts. Proximal or distal extensions were used for type I and III endoleak in 9 cases. Fenestrated, scallop and bifurcated stent grafts were used to reconstruct the aortic arch in 3 cases. Emboli technique was used in treating type II endoleak. Thrombectomy and bypass technique were used in 4 cases with stent graft limb occlusion. One ruptured AAA accepted open surgery.

RESULTSSecondary endovascular technique were undergone in 20 (95.2%) cases. One case died in 30 days after the secondary intervention and endoleak remained after the secondary operation in 5 cases. Three cases died of the secondary intervention.

CONCLUSIONSEndoleak and limb occlusion were the chief mid-long complications after EVR. Secondary endovascular technique can be used in most cases and carries great challenges in aortic arch lesions.

Adult ; Aged ; Aged, 80 and over ; Aortic Diseases ; surgery ; Blood Vessel Prosthesis Implantation ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Stents ; adverse effects ; Treatment Outcome

BACKGROUNDSpinal anesthesia is considered as a reasonable anesthetic option in lower abdominal and lower limb surgery. This study was to determine the dose-response of intrathecal ropivacaine in patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia.

METHODSSeventy-five patients with scarred uterus undergoing elective cesarean delivery under combined spinal-epidural anesthesia were enrolled in this randomized, double-blinded, dose-ranging study. Patients received 6, 8, 10, 12, or 14 mg intrathecal hyperbaric ropivacaine with 5 μg sufentanil. Successful spinal anesthesia was defined as a T4sensory level achieved with no need for epidural supplementation. The 50% effective dose (ED50) and 95% effective dose (ED95) were calculated with a logistic regression model.

RESULTSED50and ED95of intrathecal hyperbaric ropivacaine for patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia (CSEA) were 8.28 mg (95% confidence interval [CI]: 2.28-9.83 mg) and 12.24 mg (95% CI: 10.53-21.88 mg), respectively.

CONCLUSIONWhen a CSEA technique is to use in patients with scarred uterus for an elective cesarean delivery, the ED50and ED95of intrathecal hyperbaric ropivacaine along with 5 μg sufentanil were 8.28 mg and 12.24 mg, respectively. In addition, this local anesthetic is unsuitable for emergent cesarean delivery, but it has advantages for ambulatory patients.

Adult ; Amides ; administration & dosage ; therapeutic use ; Anesthesia, Epidural ; methods ; Anesthesia, Spinal ; methods ; Cesarean Section ; methods ; Cicatrix ; Dose-Response Relationship, Drug ; Female ; Humans ; Pregnancy ; Sufentanil ; administration & dosage ; therapeutic use ; Uterus ; pathology

OBJECTIVETo evaluate results of 1310 knees of meniscal treatments by arthroscopy and to present good method of meniscal treatment.

METHODSTheir age, traumatic mechanism and effects under arthroscopy were analysed in a series of 254 patients with meniscal injuries, there were 880 males and 374 females, the average of the patients was 25.5 years. The meniscal repair in 68 knee, partial meniscectomy in 756 knee, total meniscectomy in 480 knee and conservative treatment in 6 cases.

RESULTSThe patients were followed up 1 to 12 years with the average of 4 years and 3 months. The mean Lysholm score was 86.3 points in arthroscopic meniscal repair, 84.0 points in partial meniscectomy and 76.1 points in total meniscectomy. The mean Lysholm 98.7 points in all children patients with conservative treatment. They showed significant difference (P < 0.01) in the results of three treatments.

CONCLUSIONSMeniscal injuries should not cut off as it, should be repaired in 5 mm from meniscus to synovium and or partial meniscectomy. The general adoption is not the surgical operation on meniscal injuries of the child.

Adolescent ; Adult ; Age Factors ; Arthroscopy ; Casts, Surgical ; Child ; Female ; Follow-Up Studies ; Fracture Fixation ; methods ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; surgery ; Middle Aged ; Tibial Meniscus Injuries ; Treatment Outcome

BACKGROUND: As a reliable biomechanical model, human fresh isolated cervical specimens provide the basis for studying the pathogenesis of cervical vertigo from the perspective of blood flow of vertebral artery.There is a lack of an in vitro cervical model that can simulate the physiological state of the cervical vertebrae and achieve complex posture, as well as can measure the blood flow of vertebral artery. OBJECTIVE:To study the influence of variant position of human fresh isolated cervical vertebrae on the blood flow of vertebral artery in vitro through constructing the fresh specimen of cervical vertebral artery determination model. METHODS: Six human fresh isolated cervical specimens were selected for constructing the vertebral artery determination model. The pressure of human vertebra artery was simulated by pressure pump. The change of normal saline height was measured by digital motion capture system dynamically under different positions. RESULTS AND CONCLUSION: (1) Eight vertebral arteries in the six models were in good condition. (2) The vertebral artery flow under neutral position was significantly richer than that under contralateral rotation-anteflexion and ipsilateral/contralateral rotation-postexion (P <0.05). (3) The vertebral artery flow under contralateral rotation-anteflexion and rotation-postexion was significantly poorer than that under natural position, ipsilateral rotation and ipsilateral rotation-anteflexion (P < 0.05). (4) In summary, the cervical vertebral artery determination model is constructed successfully that can simulate the influence of the position on vertebral artery flow. Additionally, different positions of rotation make a different effect on vertebral artery flow.

OBJECTIVETo evaluate the initial and long-term results of endovascular aneurysm repair (EVAR) in high-surgical-risk abdominal aortic aneurysm (AAA) patients.

METHODSFrom July 1997 to July 2011, 120 consecutive high-surgical-risk patients with AAA who were treated electively using a bifurcated aortic endograft were entered in a registry. There were 96 male and 24 female patients, aged from 52 to 95 years with a mean of 74 years. Follow-up protocol consisted of computed tomography angiograms or ultrasound performed at 3, 6, 9, 12 months, and annually thereafter. The main goal was evaluation of the operative mortality and the long-term survival of these patients. Secondary goals were determination of the frequency of secondary operations, the outcome of the aneurysm sac, and primary and secondary patency rates after aortic endograft placement.

RESULTSMean aneurysm diameter was (57 ± 8) mm. Thirty-seven patients were operated under local anesthesia and eighty-three under general anesthesia. Five type I endoleaks, twenty-five type II endoleaks and one type III endoleak occurred during the perioperative period. The technical success rate was 95%. Operative mortality was 2.5%. The survival rates at 1-, 3- and 5-year were 92%, 75% and 43% respectively. The mean follow up was (36 ± 3) months. Primary and secondary patency rates at 3 year were respectively 97% and 100%. Secondary intervention rate was 10% (12/120) at 5 year. The reasons included endoleaks for 7 patients, stent-grafts fracture for 2 patients, stent-grafts migration for 2 patients and stent-graft thrombosis for 1 patients.

CONCLUSIONSInitial and long-term results with endograft repair of AAA in high-surgical-risk patients were satisfactory. These results appear to justify endovascular repair for this patient population.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

OBJECTIVETo investigate the treatment strategies of peripheral arterial aneurysms.

METHODSThirty-five cases were reviewed from July 1998 to December 2007, and 28 cases were male, 7 cases were female. Eleven cases were popliteal artery aneurysms, 15 cases were femoral artery aneurysms, 4 cases were extracranial carotid aneurysms and 5 cases were subclavian artery aneurysms. All cases had either open procedures or endovascular procedures.

RESULTSSurgical open procedures were performed on 24 cases, and endovascular procedures were performed on 11 cases. The perioperative complication rate were 16.7% (4/24) and 0% for open and endovascular groups respectively. The average follow-up time was 41 months (7 months to 8 years). The accumulative five year patency were 61% and 48% for surgical grafts and stent grafts respectively. Two cases died of diseases and one had stroke during follow-up.

CONCLUSIONSSurgical open repair is still standard procedure for most peripheral arterial aneurysms and endovascular repair may have its own advantage for high risk patients.

Adult ; Aged ; Aged, 80 and over ; Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Female ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; surgery ; Retrospective Studies

BACKGROUNDAs an alternative to open aneurysm repair, endovascular aortic repair (EVAR) has been applied to ruptured abdominal aortic aneurysm (rAAA). The aim of this study was to evaluate the immediate and long-term outcomes of EVAR for rAAA.

METHODSFrom July 1997 to September 2007, 20 men and six women with rAAA (median age, 68 years) were treated with EVAR. Most patients with suspected rAAA underwent emergency computed tomographic angiography (CTA). The procedure was performed under general or local anesthesia. Endovascular clamping was attempted in hemodynamically unstable patients. Bifurcated endografts and aorto-uni-iliac (AUI) endografts with crossover bypass were used. Patients had CT scan prior to discharge, 3, 6, 12 months after discharge, and annually thereafter.

RESULTSTime between diagnosis and EVAR ranged from 1 hour to 5 days. EVAR was performed under general anesthesia in 21 patients, and under local anesthesia in five patients. Endovascular aortic clamping was performed in four patients. There was no conversion to open surgery during EVAR. Stent-graft insertion was successful in all patients. One patient died during EVAR from acute myocardial infarction. Ten patients had systolic blood pressure < 80 mm Hg. Eleven patients received a blood transfusion. Mean aneurysm size was (47 +/- 12) mm. Mean ICU stay was (8 +/- 3) days, mean hospital stay (18+/- 6) days, and mean procedure time (120 +/- 32) minutes. The 30-day mortality was 23% (6/26 patients), and major morbidity 35% (9/26 patients). Early endoleak occurred in 8/26 patients (31%). The mean follow-up was (18 +/- 7) months. No patient demonstrated migration of the stent-graft.

CONCLUSIONSEVAR is a safe and effective option for treatment of acute rAAA, independent of the patient's general condition. Immediate and mid-term outcomes are favorable, but long-term outcome is unknown. Multi-center studies are necessary to establish the role of EVAR for rAAA.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; mortality ; therapy ; Blood Vessel Prosthesis Implantation ; adverse effects ; methods ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome