Objective To investigate the changes of electrode impedance,threshold(THR),maximum comfortable level(MCL),and dynamic range(DR),providing the basis for debugging after operation in congenital deaf children. Methods A respective study was carried out on 20 cases of congenital deaf children who were implanted with cochlear Med?EL SONATAti100. The measurements and changing ranges of electrode imped?ances,THR,MCL and dynamic range during the operation and at postoperative one month,three months,and six months were statistically analyzed. Results Electrode impedances were the lowest during the operation and the highest at one month after operation(P<0.01). The electrode imped?ance for the apical cochlear group was statistically different from that for other groups at one month(P<0.05). After three and six months,there were statistically significant differences between groups(P<0.01). THR at six months was lower than that at three months(P<0.05). MCL at three months was higher than that at one month(P<0.01). DR showed an increasing trend(P<0.05). There was no correlation of perioperative and post?operative electrode impedance with THR,MCL,and DR(P>0.05). Conclusion The electrode impedances varied due to different electrode posi?tion. The vales of THR,MCL and DR were unrelated with electrode impedance. DR was gradually increasing,MCL reached steady state earlier than THR. It is important that THR should be debugged at three months after operation and MCL should be debugged at six months.

Objective To investigate the application of using urine ACR at different time points instead of 24-hour urinary albumin (24 h UA) for screening of early renal injury in patients with type 2 diabetes. Methods The 24-h urine samples at different time pointsfrom 89 hospitalized patients were collected. The correlations of the ACR of urine samples at different time points were compared with the 24-h UA. When the 24-h UA was taken as the standard,the receiver operating characteristic (ROC) curves of urine ACR at different time points were established and analized. Results No significant differences in urine ACR between the morning urine group [ACR 9.02 (5.69~ 11.64)mg/mmol] and the random urine group [ACR 8.65 (5.80 ~ 11.83) mg/mmol] (P > 0.05). A positive correlation was observed between the morning urine ACR and the random urine ACR (r = 0.951,P < 0.01), however, the ACR of the morning and the random urine group were all positively correlated with the 24-h UA (r=0.886, 0.859, P<0.01). There were no significant differences in the sensitivities and the specificities between the morning and the random urine specimens in screening for albuminuria (92.6%vs 90.1%, and 87.5%vs 87.5%, respectively). When the 24-h UA was taken as the standard,the area under the ROC curves of the ACR in the random urine specimens and the morning urine specimens were 0.954 ± 0.022 and 0.960 ± 0.021 , respectively. There were no statistical differences between these two groups. Conclusions The morning urine and the random urine ACR , instead of the 24-h UA , could be used for both the early screening and monitoring of the renal injury , and the random urine ACR detection is simple ,convenient and accurate for patients.

OBJECTIVE: To evaluate the instructional effect of Multi-slice (MSCT) in the cochlear implantation pre- and post-operatively, and to contrast the image feature between the X-ray and the MSCT three-dimensional reconstruction of inner ear with implanted electrode. METHOD: Twenty-four cochlear implant (MEDEL Combi 40+) recipients,in No. 1 Hospital of China Medical University from January to October 2014, were involved in this study. Among them, 18 were male and 6 female,with an average age of 4 years. MSCT and three dimensional reconstruction of inner ear were performed in all of the 24 implanted inner ears pre- and post-operatively. And X-ray plain film were examined by using 60° lateral oblique position postoperatively. All data of the spiral CT scan with axial 1 mm image slices were transferred to workstation for three-dimensional reconstruction (direct volume rendering) of the inner ear. RESULT: In 1 of the 24 cases, preoperative three-dimensional reconstruction CT scan reveal that the length of the cochlear was shorter than the electrode. And this was confirmed by MSCT postoperatively that the electrode couldn't be inserted by full length. The insertion depth of the electrode can be evaluated directly by MSCT. Moreover, each of the electrode pairs can be identified clearly. CONCLUSION MSCT plays an indispensable role in the preoperative evaluation of cochlear implantation. Postoperative evaluation by three-dimensional reconstruction of inner ear provide more accurate image to show the electrode insertion depth in the cochlea. MSCT combined with curved planar reformation to measure cochlear length could provide guidance in choosing the more adaptive electrode. And MSCT is superior to DR in demonstration of electrode postoperatively.
Child, Preschool ; China ; Cochlea ; anatomy & histology ; Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Female ; Humans ; Male ; Postoperative Period ; Preoperative Care ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

Objective: To observe the effect of electroacupuncture (EA) at Huantiao (GB 30) and Weizhong (BL 40) on thigmesthesia, gait function, and expression levels of serum immunoglobulin G (IgG) and immunoglobulin M (IgM) in rabbits with lumbar intervertebral disc herniation (LIDH). Methods: Forty healthy New Zealand rabbits were randomly divided into a blank control group, a model group, an EA at acupoint group and an EA at non-acupoint group, with 10 rabbits in each group. The LIDH pathological model of rabbit was established using the self-made LIDH model maker. The thigmesthesia and gait function of rabbits were recorded by Siegal method. The serum IgG and IgM expression levels were detected by enzyme-linked immunosorbent assay. Results: EA at Huantiao (GB 30) and Weizhong (BL 40) could improve the clinical symptoms of thigmesthesia and gait function, and inhibit the expressions of serum IgG and IgM in the LIDH rabbits, which were significantly different compared with those in the model group and EA at non-acupoint group. Conclusion: EA at Huantiao (GB 30) and Weizhong (BL 40) can improve the clinical symptoms of LIDH rabbits, which is associated with inhibition of the serum IgG and IgM expressions and reduction of the immunoinflammatory factor release. This may be one of the mechanisms of EA at Huantiao (GB 30) and Weizhong (BL 40) in the treatment of LIDH.

OBJECTIVETo observe effects of Ligustrazine on serum S100p protein and neuron-specific enolase (NSE) in elderly patients undergoing orthopedics operations.

METHODSTotally 60 patients undergoing selective total hip replacement, 65-80 years old, who were in line with American Society of Anesthesiologists (ASA) grade I or II, were randomly assigned to the Ligustrazine group (Group L) and the normal saline control group (Group S). The right internal jugular vein catheters were placedcephalad and ensured theirs tips in jugular venous bulbs after anesthesia induction and tracheal intubation. Patients in Group L received 2 mg/kg Ligustrazine Injection (40 drops within one minute) and those inGroup S received equal volume of normal saline via central veins before operations. Other medicines were the same for all patients during and after operation. Five millimeter blood sample was collected frominternal jugular venous bulbs before operation (T0), 24 h (T1), 72 h (T2), 168 h (7th day, T3) after operation. Serum was collected after centrifuge. S100β protein and NSE concentration were analyzed usingELISA. Mini-mental state examinations (MMSE) were scored by the same doctor at T0, T1, T2, and T3,respectively.

RESULTSThere was no statistical difference in MMSE scores, serum S1000 protein, or NSE at TO (P > 0.05). Compared with TO, S100 P protein and NSE concentration increased and MMSE scores decreased at T1, T2, and T3 in the two groups. All indices except S100P protein and NSE at T3 were statistically different between Group L and Group S (P < 0.05).

CONCLUSIONSerum S100P protein and NSE could be changed by pre-operation injecting Ligustrazine at certain dose in elderly patients undergoing orthopedics operations.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Humans ; Phosphopyruvate Hydratase ; blood ; Pyrazines ; therapeutic use ; S100 Calcium Binding Protein beta Subunit ; blood

OBJECTIVETo explore the immune mechanism of moxibustion on protecting gastric mucosa injury.

METHODSForty healthy SD rats were randomly divided into four groups: a blank group, a model group, a moxibustion acupoint group and a moxibustion non-acupoint group, 10 rats in each one. Eight days before model establishment, moxibustion at "Zusanli" (ST 36), "Zhongwan" (CV 12), "Guanyuan" (CV 4), "Pishu" (BL 20) and "Weishu" (BL 21) was applied in the moxibustion acupoint group while these acupoints' controlled points were selected in the moxibustion non-acupoint group, and no treatment was given in the model group, once a day in three groups for continuous 16 days. The helicobacter pylori (Hp) model was established by intragastric administration of Hp. HE staining microscopic examination was used to observe inflammation severity in gastric mucosa, and enzyme-linked immunosorbent assay (ELISA) was adapted to measure content of heat shock protein (HSP) 72, TNF-alpha and IL-1beta, and real-time quantitative PCR was used to measure the expression of TLR2 mRNA, TLR4 mRNA, CD14 mRNA and MyD88 mRNA in peripheral blood mononuclear cells, and western blot method was used to measure content of NFkappaB and IkappaBalpha in peripheral blood mononuclear cells.

RESULTSCompared with the blank group, the expression of HP could be seen in the smear of gastric mucosa by Gram's staining in the model group; the inflammation severity score was obviously increased as well as content of serum HSP 72 and TNF-alpha and IL-1beta in gastric tissue; and expression of TLR2, 4 mRNA, CD14 mRNA, MyD88 mRNA, NFkappaB was increased (P < 0.01), but the expression of IkappaBalpha was reduced (P < 0.05). After the moxibustion, the inflammation severity score was reduced in the moxibustion acupoint group, and the content of serum HSP 72 was increased, and the expression of TNF-alpha and IL-1beta in gastric tissue and expression of TLR2 mRNA, TLR4 mRNA, CD14 mRNA, MyD88 mRNA and NFkappaB were reduced (P < 0.01), but the expression of IkappaBalpha was increased (P < 0.05). The differences between the moxibustion non-acupoint group and the model group were not significant (P > 0.05).

CONCLUSIONThe pretreatment of moxibustion at acupoints could induce the over expression of serum HSP 72. By combining TLR 2 and 4 receptors to trigger receptor signal transduction pathways, the releases of downstream signal substances are regulated; as a result, the releases of related immune substances are regulated to relieve the gastric mucosa injury of rats with HP gastritis.

Acupuncture Points ; Animals ; Female ; Gastritis ; immunology ; therapy ; Helicobacter Infections ; genetics ; immunology ; therapy ; Helicobacter pylori ; physiology ; Humans ; Interleukin-1beta ; genetics ; immunology ; Male ; Moxibustion ; NF-kappa B ; genetics ; immunology ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; genetics ; immunology

Background: Thoracolumbar junction (TLJ) is the transitional area between the lower thoracic spine and the upper lumbar spine. Vertebral compression fractures and proximal junctional kyphosis following spine surgery often occur in this area. Therefore, the study of development and mechanisms of thoracolumbar junctional degeneration is important for planning surgical management. This study aimed to review radiological parameters of thoracolumbar junctional degenerative kyphosis (TLJDK) in patients with lumbar degenerative kyphosis and to analyze compensatory mechanisms of sagittal balance. Methods: From January 2016 to March 2017, patients with lumbar degenerative kyphosis were enrolled in this radiographic study. Patients were divided into two groups according to thoracolumbar junctional angle (TLJA): the non?TLJDK (NTLJDK) group (TLJA <10°) and the TLJDK group (TLJA≥10°). Complete spinopelvic radiographic parameters were analyzed and compared between two groups. Pearson or Spearman correlation coefficients and independent two?sample t?test or Mann?Whitney U?test were used. Results: Atotal of 77 patients with symptomatic sagittal imbalance due to lumbar degenerative kyphosis were enrolled in this study. There were 34 patients in NTLJDK group (TLJA <10°) and 43 patients in TLJDK group (TLJA ≥10°). The median angle of lumbar lordosis (LL) in the NTLJDK or TLJDK groups was 23.40° (18.50°, 29.48°) or 19.50° (13.30°, 24.55°), respectively. The median TLJAs in all patients and both groups were ?11.20° (?14.60°, ?4.80°), ?3.70° (?7.53°, ?1.73°), and ?14.30° (?17.45°, ?13.00°), respectively. In the NTLJDK group, LLwas correlated with thoracic kyphosis (TK; r = ?0.400, P = 0.019), sacral slope (SS; r = 0.681, P < 0.001), and C7?sagittal vertical axis (r = ?0.402, P = 0.018). In the TLJDK group, LL was correlated with TK (r = ?0.345, P = 0.024), SS (r = 0.595, P < 0.001), and pelvic tilt (r = ?0.363, P = 0.017). There were significant differences in LL, TLJA, TK, SS, and pelvic incidence (PI) between two groups. Conclusions:Although TLJDK is common in patients with lumbar degenerative kyphosis, it might be generated by special characteristics of morphology and biomechanics of the TLJ. To maintain sagittal balance, pelvis back tilt might be more important in patients with TLJDK, whereas thoracic curve changes might be more important in patients without TLJDK.

Both tetrandrine (Tet) and 5-bromotetrandrine (BrTet) can effectively reverse P-glycoprotein (P-gp)-mediated multidrug resistance (MDR). The structure of multidrug resistance associated protein 7 (MRP7) has its own specificity and difference compared with other members of the MRP family. This study was aimed to investigate whether Tet and BrTet can inhibit the expression level of MRP7 so as to further look into the mechanisms of the reversal effects of Tet and BrTet on MDR. The inhibitory effects of daunorubicin (DNR) used alone on the proliferation of K562 and K562/A02 cells were evaluated by MTT assay, the IC(50) of DNR and drug resistant folds were calculated. The mRNA level of MRP7 was tested by real-time PCR, and the protein levels of MRP7 and P-gp were tested by Western blot. The DNR accumulation was analyzed by flow cytometry (FCM). The results showed that the resistance of K562/A02 cells to DNR was 23.65-folds of that of K562 cells. After administration of 1 µmol/L Tet or 2 µmol/L BrTet, the mRNA level of MRP7 in the K562/A02 cells decreased to 2% and 12% respectively, and the protein level of MRP7 decreased by 53.2% and 83.7% respectively. The protein level of P-gp decreased by 58.47% and 52.20% in the 1 µmol/L Tet and 2 µmol/L BrTet groups. FCM detection showed that 1 µmol/L Tet and 2 µmol/L BrTet significantly increased the accumulation of DNR in K562/A02 cells by 94.32% and 271% respectively. It is concluded that Tet and BrTet both can reverse MDR in vitro. The mechanisms may be related to the inhibition of MRP7 overexpression and the increase of anticancer drug concentration in cells. At the same molar concentration, the effects of Tet and BrTet in inhibiting the protein level of MRP7 expression do not show significant difference.
Benzylisoquinolines ; pharmacology ; Down-Regulation ; drug effects ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Humans ; K562 Cells ; Multidrug Resistance-Associated Proteins ; metabolism

OBJECTIVETo study and compare the anti-inflammatory effect and molecular mechanism of artemisinin and dihydroartemisinin.

METHODMouse mononuclear macrophage RAW264.7 cells were stimulated to release inflammatory mediators such as TNF-alpha, IL-6 and NO, in order to assess the drugs' inhibitory effect on macrophage's release of above inflammatory mediators. The levels of TNF-alpha and IL-6 were determined by ELISA and the cytotoxicity was determined by MTT method. The protein expression of iNOS, COX-2 and beta-actin were tested by Western blot. The enzymatic activity of COX-2 was determined by colorimetric method.

RESULTDihydroartemisinin significantly inhibited LPS-induced release of TNF-alpha, IL-6 and NO from RAW264.7 in mice with the concentration range of 12.5 - 100 micromol x L(-1), and showed good dose dependence. Artemisinin only inhibited the IL-6 release to a certain extent.

CONCLUSIONDihydroartemisinin inhibits macrophages from releasing inflammatory factors TNF-alpha and IL-6 and inflammatory mediators NO by down-regulating iNOS protein. Artemisinin may help dihydroartemisinin to show its anti-inflammatory effect through metabolism.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Artemisinins ; pharmacology ; Cell Line ; Gene Expression ; drug effects ; Inflammation Mediators ; immunology ; Interleukin-6 ; genetics ; immunology ; Macrophages ; drug effects ; immunology ; Mice ; Nitric Oxide ; immunology ; Tumor Necrosis Factor-alpha ; genetics ; immunology

Objective To evaluate the role of nutritional parameters in prognosis,especially in the early and late mortality of hospital-acquired acute kidney injury (AKI) patients.Methods This study was a prospective cohort study conducted in a hospital comprising 1500 beds in Shanghai, China. One hundred ninety-four patients with hospital-acquired AKI, as determined using the RIFLE staging criteria,were enrolled as subjects after obtaining informed consent.Patients with AKI caused by postrenal obstruction,glomerulonephritis,interstitial nephritis or vasculitis were excluded.Nutritional evaluation,including subjective global assessment (SGA),anthropometric and laboratory examination,was conducted. Other laboratory measurements and clinical data were recorded.The primary outcome was early mortality (≤ 7 days) and late mortality (8-28 days) after enrolling into the study. Results AKI patients at enrollment were characterized by a high prevalence of malnutrition as determined by SGA, anthropometric and laboratory examination.Univariate analysis showed that the SGA,the serum levels of prealbumin,cholesterol and total lymphatic cells, and the Maastricht index were significantly different among early mortality,late mortality and survival groups.The serum prealbumin and cholesterol levels in the early death group were significantly lower than those in the survival and late death groups (P＜0.05).Multivariate analysis revealed that SGA,albumin,prealbumin and cholesterol remained independently and significantly associated with early mortality after adjusting for age,sex,dialysis,ventilation,hemoglobin,platelets,bilirubin,and Glasgow coma score.The areas under the receiver operating characteristic curve to predict early mortality for albumin,prealbumin and cholesterol were 0.591,0.736 and 0.603,respectively,with that of prealbumin significantly higher than others (P＜0.05). Conclusion Low levels of serum prealbumin,albumin and cholesterol at enrollment are independtly associated with increased early mortality in hospital-acquired AKI patients.