Adult ; Cardiac Catheterization ; adverse effects ; Female ; Heart Septal Defects, Ventricular ; surgery ; Hemolysis ; Humans ; Postoperative Complications ; etiology

[Objective]To determine a surgical plan for the treatment of scoliosis. [Methods]A consecutive series of scoliosis patients were admitted from Oct. 1,2007 to Feb. 29,2008. The preliminary operation programs (including diagnosis,operative approach,upper instrumented vertebra,lowest instrumented vertebra,whether to need selective fusion of main thoracic curve and multiple operations) were formulated by the attending physicians.Preliminary operation programs were decided on by a symposium. A comparison was made between the two kinds of programs.[Results]Data from 143 consecutive scoliosis patients were reviewed. The average age at the time of operation was 16.1 years (2-49 years) and the average curve was 56.9? (range,15?~115? ). There were 6 spine surgeons involved in the study. The accepted programs formulated by the symposium occurred in 46 (32.2%) cases. One of these cases was changed in surgical approach and need selective fusion of main thoracic curve,19 in upper instrumented vertebra and 29 in lower instrumented vertebra. There were no changes in diagnosis and need multistage operations. Operation programs were difficult to formulated in patients aged less than 20,with Cobb's angle≤70?and thoracic curve patterns. [Conclusion]Preoperative symposium for treatment of idiopathic scoliosis influenced the preliminary operation programs in 32.2%. Sympoium appears to have a significant role in drawing up a more perfect operation program.

ObjectiveTo investigate the protective effect of astragalosideⅣ pretreatment against liver ischemia/reperfusion (I/R) injury in mice.MethodsSixty male C57BL/6 mice were randomized into four groups (15 mice in each group):group A:sham surgery with saline injection,group B:sham surgery with astragalosideⅣ injection,group C:I/R group with saline injection,group D:I/R and astragalosideⅣ injection.Mice were pretreated by daily intraperitoneal injection of saline or astragalosideⅣ (24 mg · kg-1 · d-1 ) for one week.The mouse partial liver model of I/R injury was established,and samples were collected at the 24 h after the I/R injury.Serum ALT and AST levels were determined,the histologic changes were observed by H&E staining under the light microscopy,whereas the nuclear factor (NF)-κB was assessed with Western blotting.Serum IL-1β,IL-6,and TNF-α levels were measured by enzyme-linked immunosorbent assay (ELISA). ResultsSerum ALT and AST levels significantly decreased and the histological damage was significantly alleviated in astragalosideⅣ treated I/R group as compared with saline I/R group [ AST:C:(4290± 292) U/L vs.D:(2373± 416) U/L t =0.844 ; ALT:C:(4146±500) U/L vs.D:(2318±289) U/L t =7.08 P ＜0.05].In comparison with group 3,astragalosideⅣ reduced NF-κB nuclear expression.ELISA showed astragalosideⅣ significantly inhibit the levels of IL-1 β,IL-6,and TNF-α in the serum (IL-1β:t =10.04;IL-6:t =6.281;TNF-α:t =6.817; P ＜0.05).ConclusionsPretreatment with astragaloside Ⅳ effectively protect against liver ischemia/reperfusion injury in mice.

Objective To investigate the effects of human Rrain-derived neurotrophic factor-gamma fetopro-tein (hBDNF-GFP) gene-transfected neural stem cell (NSC) transplantation on BDNF expressions in the retina of rots after optic nerve (ON) crush injury. Method ①Seventy-eight Sprague-Dawley (SD) rats were randomly as-signed into a control group (n = 6) and ON crush group (n = 72). In the ON crush group, the right ON was crushed while the left NO was exposed as sham injury. Rats in the ON crush group were divided into three sub-groups: PBS group (intravitreons injection of 0.01 mol/L phosphate buffered solution); GFP group (intravitreous transplantation of GFP gene-transfected NSCs); and hBDNF-GFP group (intravitreous transplantation of hBDNF-GFP gene-transfected NSCs). Rats were sacrificed 3, 7, 14 and 28 days after transplantation, and BDNF expres-sions in retinal homogenates was detected by using enzyme-linked immunosorbent assay (ELISA). ②The hBDNF-GFP-NSCs were transplanted intravitreous into six rats after ON crush injury. Following this, two rats were sacri-riced 2, 4 and 8 weeks after transplantation. The survival and location of NSCs in host retina were observed by frozen section analysis. ③Adult SD rats were randomly divided into four groups: control group (n = 5); NSC group (NSC transplantation, n = 10); GFP-NSC group (GFP-NSC transplantation, n = 10); and hBDNF-GFP-NSC group (hBDNF-GFP-NSC transplantation, n = 10). Four and eight weeks after transplantation, five rats from every group were sacrificed. Western blot analysis was used to determine retinal BDNF expression. Results ① There was no significant difference in BDNF expression between the control group and sham-injury groups (P >0.05). Three days after NSC transplantation, BDNF expression increased significantly in the three injured sub-groups compared with the sham-injury group, (P < 0.05), whereas no significant inter-group differences in BDNF expressions among three injured sub-groups were observed (P > 0.05). Seven days after transplantation, there was a significant difference in BDNF expression between the GFP-NSC group and the sham-injury groups (P <0.05), whereas there were no significant differences in BDNF expressions among the PBS, hBDNF-GFP-NSC and sham-injury groups (P > 0.05). Fourteen and 28 days after transplantation, BDNF expressions decreased in the PBS group and the GFP-NSC groups, while BDNF expressions in the hBDNF-GFP-NSC group increased significant-ly compared with the other three groups (P < 0.05); ②Frozen section showed that transplanted hBDNF-GFP-NSCs could survive and gradually extended to all layers of the host retina. ③Westem blot revealed there were no differences in BDNF expressions between 4-week and 8-week intervals in the hBDNF-GFP-NSC group. Compared with other three groups, BDNF expressions in the retina increased significantly after hBDNF-GFP-NSC transplanta-tion. Conclusions The hBDNF-GFP gene-trausfected NSCs can survive in the host retina and BDNF expressions are stable at a high level.

Objective To observe liver functional lesion caused by combination chemotherapy containing or not containing oxaliplatin. Methods Data from 42 patients with liver functional lesion caused by chemotherapy between March 2005 and October 2007 were analyzed. All patients were diagnosed through histology or cytology detection and received chemotherapy only. Different drugs were. admitted,based on different tumors. Before chemotherapy, each patient had normal liver function without liver lesions such as liver metastasis, Hepatitis B and C, hepatic cirrhosis, etc. Furthermore, 22 received FOLFOX-4 in containing oxaliplatin group while the remaining 20 received chemotherapy excluding oxaliplatin. When liver functional lesion without the influence of any liver protectant was first observed, ALT, AST, TBIL, DBIL, IBIL, ALP, GGT and the WHO criteria of liver toxicity were analyzed. T test and Wilcoxon rank sum test were used for data analysis. Results All together 90 cycles, median 2.14 cycles, were given. According to WHO criteria of liver toxicity, 13 cases were in grade O, 21 in grade Ⅰ, 7 in grade Ⅱ, and 1 in grade Ⅲ. ALT and AST were significantly high after chemotherapy(P <0.05). Moreover, ALT and AST were significantly higher in containing oxaliplatin group than non oxaliplatin group after chemotherapy(P <0.05). Chemotherapy had no influence on bilirubin. The population distribution of accumulative chemotherapy cycles and WHO criteria of liver toxicity was similar between two groups. Conclusion Before the intervention of liver protectant, combination chemotherapy containing oxaliplatin is more likely to have liver functional lesion than other chemotherapy without oxaliplatin. It mainly presents an increase in transaminase.

Humans ; Nasal Cavity ; Paranasal Sinuses

Objective:To explore the correlation among serum cardiac troponin I (cTnI),N terminal pro brain natri-uretic peptide (NT-proBNP)and main endpoint events of heart in patients with chronic stable heart failure.Meth-ods:The present study enrolled 95 patients with NYHA cardiac function class III~IV from Feb 2010 to Feb 2011.According to levels of cTnI and NT-proBNP,the patients were divided into cTnI negative group (n=60)and cTnI positive group (n=35);NT-proBNP negative group (n=40)and NT-proBNP positive group (n=55),all patients were followed up for two years,and the main endpoint events were cardiogenic sudden death and rehospitalization caused by acute aggravation of heart failure.Results:Compared with negative group,the hazard ratio (HR)of end-point events was 2.69 and confidence interval (CI)was 1.54~ 4.72,P = 0.002 in cTnI positive group;HR was 2.54 and CI was 1.35~4.78,P =0.003 in NT-proBNP positive group;further interclass crossover analysis found that,when patients'cTnI and NT-proBNP were both positive,the hazard ratio of cardiac endpoint events was the highest (HR=6.34,CI 2.26~17.9,P <0.001).Conclusion:In patients with chronic stable heart failure,serum elevated levels of cardiac troponin I and N terminal pro brain natriuretic peptide are important predictors reflecting prognosis of patients with heart failure.

OBJECTIVE To analyze the situation of extended spectrum ?-lactamases(ESBLs)and AmpC enzyme produced by nosocomial Escherichia coli isolates in 2005-2007.METHODS ESBLs were detected by double disk synergy test and disk diffusion confirmatory test.AmpC enzyme was detected by the three dimensional assay.Chi square test was used to test the significance.The application of different kinds of antimicrobials before the results of etiology be presented and the resistence rate of the ESBLs both producing and no producing were compared respectively.RESULTS The detectable rate of ESBLs in E.coli isolates of nosocomial and community infection was 55.1% and 21.3% and the detectable rate of AmpC enzyme nosocomial E.coli isolates was 17.4%.All strains were 100% susceptible to meropenem and imipenem but resistant to 15 other antimicrobials in different degree.The sensitivity to Piperacillin/tazobactam,cefoperazone/sulbactam and amikacin were relatively high.CONCLUSIONS The carrying rate of ESBLs from nosocomial E.coli isolates is high and AmpC enzyme and other resistance genes,which lead to multiple drug resistance.Standardized management of antimicrobials application should be strengthened and the consciousness of rational antimicrobials utilization should be raised.

ObjectiveTo study the clinical features of stercoral bowel obstruction and perforation of colon in elderly patients MethodsThe data of 22 cases of stercoral bowel obstruction and 6 cases of stercoral perforation of colon in elderly patients in our hosital from January 1994 to December 2003 were analyzed retrospectively ResultsIn the 22 cases with stercoral bowel obstruction, 6 cases were recovered after operation, 6 cases suffered from stercoral perforation in which all cases were misdiagnosed before operation,and 2 cases were dead.ConclusionsThe prevalence of stercoral bowel obstruction and perforation of colon in elderly patients are increasing with population being aged. The cases without perforation are often recovered by non-operative therapy. The perforation case of stercoral bowel obstruction is relatively rare, easy to be misdiagnosed, and in high mortality. The Hartmanns ostomy should be the choice for the perforation.

Underlying both the angles of norm-referenced test and criterion-referenced test, the qualitative or(and)quantitative analysis and evaluation were made on the tests of 10 medical academic courses in recent 4 years in reliabil-ity and item quality. From the angle of norm-referenced test, 67.4 percent of the items had good quality, 60 percent ofthe tests could differentiate the classes and 12.5 percent of the papers could differentiate the individual person accord-ing to their reliability. However, from the angle of criterion-referenced test, approximately 90 percent of the items werequalified; 87.5% had high reliability to determine whether an examinee passes the test or not.[