Acupuncture Therapy ; adverse effects ; Humans

Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P<0.05). SBP was also significantly lower than control group 2 (P<0.05). However, heart rate, BMI, parasympathetic nerve activity and baroreceptor reflex sensitivity did not change significantly after the training (P>0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.

Adult ; Antigens, CD34 ; metabolism ; Humans ; Male ; Neoplasms, Fibrous Tissue ; metabolism ; pathology ; surgery ; Prostatectomy ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To evaluate the clinical value of 18floro-deoxyglucose positron emission tomography-CY(~(18)FDG PET-CT)in the diagnosis of lymph node metastasis from advanced esophageal carcinoma. Methods A prospective study is perfonued here to assess whether ~(18)FDG PET-CT can improve the diagnostic accuracy in lymph node metastasis for patients with advanced esophageal carcinoma.Thirty patients had undergone esophagectomy with extensive lymph node dissection.PET-CT findings were compared with that d CT with pathological finding as the final say.Results All patients were operated successfully without peri-operative complications.The pathological examination conformed metastasis in 22 patients and 49 out of 243 excised lymph nodes.In CT analysis,the sensitivity was 40.8%,specificity was 96.9%,with a diagnostic accuracy of 85.6%, The positive and negative predictive value was 76.9%,86.4% respectively;PET-CT resulted in a sensitivity of 93.9%,specificity of 91.2%,accuracy of 91.8%.The positive predictive value was 73.0% and negative predictive value was 98.3%,The difference of sensitivity(P＜0.001),accuracy(P＜0.05)and negative predictive value between the two radiological modalities was statistically significant(P＜0.001).Conclusions With a high sensitivity and accuracy in the diagnosis of lymph node metastasis,PET-CT appears necessary in preoperative examination for advanced esophageal carcinoma in the hope that surgical treatment be guided by the results of PET-CT,especially for the elder patients with poor pulmonary function or heart or brain complications. Moreover,it could be used as the basis of the conformal radiation therapy planning for inoperable patients.

Objective To evaluate the clinical value of 18-fluoro-deoxyglucose positron emission tomography-CT(~(18)FDG PET-CT) for recurrence and metastasis in treated esophageal carcinoma (EC). Methods A retrospective study is done on 37 previously treated EC patients who underwent PET-CT scans to detect recurrent or metastatic lesions.The diagnostic accuracy of ~(18)FDG PET-CT was assessed with the help of pathological finding as well as clinical or follow-up data.Results Fourty-six sites of recurrence were finally confirmed in 37 patients by cytology,pathology or follow-up data.The sensitivity,specificity and accuracy of PET-CT in detecting recurrence of all sites were 93.5% (43/46),76.9% (20/26) and 87.5% (63/72),respectively.Two false-positive findings were found both at the anastomosis and hilar nodes,which caused the decrease in the overall specificity,especially that locally.The analysis of standard uptake value (SUV) demonstrated that patients with recurrence or who died during follow-up had higher SU- Vs compared with the control group.Condusions ~(18)FDG PET-CT is highly effective in detecting recur- rence in previously treated EC patients despite the low specificity at local sites.The analysis of stardard up- take value(SUV) provides incremental value in prognosis for this patient cohart.

Objective To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma,especially in the complex cases of which the hepatic ducts are invaded.Methods Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses.The cause of hilar obstructions in these patients were all cholangiocarcinoma,including Bismuth classification type Ⅱ(n 12 ),Ⅲa(n 17),Ⅲb(n 10),and Ⅳ(n 6).Two or 3 stents were placed in the configuration of T,Y or X over the strictures.Results Stent placement with 2 or 3 endoprostheses was successful in all patients.All patients showed significant decrease in serum bilirubin level.The mortality rate within 30 days of stent placement was 2.2%(1/45).The mean survival and stent patency times were 215.3 d(26— 516 d)and 181.5 d(26—473 d),respectively.Conclusion Deploying of multiple metallic stents is an effective method to treat complex hilar cholangiocarcinoma,especially for the cases of which hepatic ducts are invaded:the henatic ducts should be drained as much as nossible.

Objective To explore expression of hypoxia inducible factor-1?(HIF-1?)in kidney cells during hypoxia/reoxygenation injury,and to study the effect of Danshen on prevention of the hypoxia/reoxygenation injury to cells.Methods Human renal proximal tubular cells(HK-2)were used as the target cell.There were 3 groups:control group,model group,Danshen group.hypoxia/reoxygenation models after neonatal asphyxia were established with liquid paraffin covering method.Expression of HIF-1? were detected with strcp avidin biotin complex(SABC)immunohistochemistry at following different time points:hypoxia 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia;and hypoxia/reoxygenation 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia/reoxygenation.Results HIF-1? was expressed mainly in HK-2's nucleus.There had low expression of HIF-1? in HK-2 cells under the normal culture,and its expression level kept rising quickly during hypoxic/reoxygenatic culture,until 4 h after the beginning of reoxygenation.Compared with the study group,the expression level of HIF-1? in HK-2 cells of the Danshen group were significantly lower at different time points(Pa

Objective To investigate and analyze the clinical and imageological features of skull base erosion in nasopharyngeal carcinoma( NPC). Methods 67 NPC patients proved by pathology were retrospectively reviewed. All patients underwent both CT and MRI plain plus enhancement scan. Scan slices were performed from oral pharynx (lower border of second cervical vertebra) to suprasellar cistern by axial CT scans and axial, sagittal and coronal MRI scans. Results (1) 52 patients with skull base erosion were found with MRI, and only 35 patients with CT. The following structures and figures were difined with CT and MRI respectively: pterygoid plates 8,14; clivus 22,25 ; petrous apex 25 ,28 ; sphenoid body or sinus 19,25; sphenoid wing 9, 12; cavernous sinus 14,17. The display difference between CT and MRI had statistical significance ( x2= 9. 47 , P = 0. 02). (2) CT- defined skull base erosion was most bone destruction , however, not only bone destruction but also tumor crossing skull base structure could be defined by MRI. (3) The incidence of headache was 82.7% (43/52) , cranial nerve palsy was 67. 3% (35/52) , both headache and cranial nerve palsy was 57. 7% (30/52). Conclusion Headache and cranial nerve palsy are primary characteristics of the skull base erosion in NPC. MRI is superior to CT in defining both bone erosion and brain tissue abnormality.

OBJECTIVETo investigate the clinical outcomes of cannulated screw combined with buttress plate in treating transarticular shear fractures of the distal humerus.

METHODSFrom July 2008 to December 2011, 17 patients with shear fractures of the distal humerus were treated with cannulated screw combined with buttress plate. Among them, included 10 males and 7 females aged from 20 to 59 years old (mean 36.5). All the fractures were classified into type I (8 cases), type II (1 case), type III (3 cases) and type IV (5 cases) according to Bryan-Morrey and McKee classification. According to AO/ASIF classification, 10 cases were type 13B3.1, 7 cases were type 13B3.3; according to Dubberley classification, 5 cases with type 1A, 2 cases with type 1B, 2 cases with type 2A, 2 cases with type 2B, 4 cases with type 3A, 2 cases with type 3B. There were 12 cases with fresh injuries, 4 cases with old injuries. All fractures were closed injuries. Complications and range of motion of elbow were observed, and clinical efficacy were evaluated by Broberg-Morrey standard.

RESULTSAll patients were followed up with a mean time of 21.3 months (ranged, 18 to 24). All fractures obtained bone healing from 10 to 15 weeks with a mean of 12.5 weeks. No malunion or delayed healing occurred. Two cases occurred ossification in lateral collateral ligament attachment. 2 cases occurred heterotopic ossification in the capitellum in front of capsule joint. The range of elbow extension was (16 +/- 7) degrees, flexion was (115 +/- 9) degrees, the average are of pronation and supination was (65 +/- 5) degrees and (60 +/- 5) degrees respectively. According to Broberg-Morrey standard, there were excellent in 7 cases, good in 8 cases, fair in 2 cases, and average score was 92.44 +/- 4.64.

CONCLUSIONFor transarticular shear fractures of the distal humerus, classification should be performed according to preoperative X-ray and CT, cannulated screw and buttress plate combined and early function rehabilitation could recover elbow function.

Adult ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular

Exercise Test ; Female ; Heart Sounds ; physiology ; Humans ; Male ; Phonocardiography ; methods ; Pregnancy ; Stress, Physiological ; physiology ; Young Adult