Objective To assess the effectiveness of the clinical pathway for the treatment of advanced schistosomiasis he-patic fibrosis. Methods The duration of hospital stay,gross hospitalization expense,individual-paid expense,interior diame-ter of portal vein,levels of four serum hepatic fibrosis-related parameters(PIIIP,CIV,HA,and LN),and activities of ALT, AST andγ-GT were assessed and compared between the advanced schistosomiasis patients receiving the clinical pathway and ones receiving non-clinical pathway. Results There were 142 advanced schistosomiasis patients with hepatic fibrosis receiving the clinical pathway of anti-hepatic fibrosis. Compared with the patients receiving non-clinical pathway ,the gross hospitalization expenses reduced by 11.2％(t=6.310,P<0.05),and the individual-paid expenses reduced by 16.1％(t=4.326,P<0.05). The mean HA level was twice higher than the normal range,with a positive rising from 70.4％to 83.1％,and the abnormal rates of CIV andγ-GT were 64.1％and 28.9％respectively. Conclusions The clinical pathway can drastically reduce the treatment expenses in advanced schistosomiasis patients with hepatic fibrosis. However,the patients have a trend towards the persistent disease progression. Therefore,the researches of more effective therapeutic methods for advanced schistosomiasis hepatic fibro-sis are urgently needed.

OBJECTIVETo observe the effect of Wenyang Yiqi Huoxue Recipe (WYHR) on the apoptosis of photoreceptor cells in retinal degeneration slow (RDS) mice, and to investigate its molecular mechanisms.

METHODSRDS mice were randomly divided into the model group and the Chinese medicine group,and C57BL/6J mice were selected as the normal control group. Each group consisted of 4 female mice and 2 male mice. Mice in the Chinese medicine group were administered with WYHR (10 mg/g) by gastrogavage since mating. Baby mice drunk WYHR decoction instead of drinking water once they were born. The offspring were administrated with low dose WYHR decoction by gastrogavage from the 7th postnatal day, and the dose was increased to that for adult mice from the 21st postnatal day. Physiological saline was administrated to mice in the model group and the normal control group by gastrogavage. At 18, 28 and 48 postnatal days, electroretinogram (ERG) was used to evaluate the retina functional variation, and the apoptotic rate of photoreceptor cells was determined by TUNEL staining. HE staining was performed. The number of photoreceptor cells of the outer nuclear layer was calculated. Furthermore, effect of WYHR on Rhodopsin and basic fibroblast growth factor (bFGF) expression was examined using immunochemical assay.

RESULTSCompared with the model group, a- and b-wave latency and amplitude, as well as the bFGF expression sharply increased in the Max-ERG of the Chinese medicine group (P < 0.05, P < 0.01) at 18 postnatal days. At 28 and 48 postnatal days, a- and b-wave latency and amplitude sharply increased, photoreceptor cell layer numbers of the outer nuclear layer obviously increased, the apoptosis rate of retinal photoreceptor cells obviously decreased, expressions of Rhodopsin and bFGF in the Chinese medicine group significantly increased (P < 0.05, P < 0.01).

CONCLUSIONWYHR could effectively inhibit the apoptosis of photoreceptor cells in RDS mice, which might be attributed to up-regulating bFGF expression.

Animals ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Photoreceptor Cells, Vertebrate ; cytology ; drug effects ; Retinal Degeneration ; metabolism ; pathology

OBJECTIVE: To establish standardized methods and parameters of the isolated heart coronary angiography through the experiment of in vitro porcine heart by MSCT. METHODS: Based on different perfusion volume (50, 60 and 70 mL) and different perfusion-imaging time (5, 10 and 20 min), the in vitro porcine coronary artery was injected liposoluble and water-soluble contrast agents using remodel angiography equipment and scanned by MSCT. And the 3D image results were compared. The images were recorded and evaluated by 2 radiologists and analyzed by statistical software. RESULTS: Liposoluble contrast agent affected the images by damaging and infiltrating the fats around the coronary artery, while the water-soluble contrast agent didn't affect the images. The groups with 60 mL or 70 mL perfusion and 5 min perfusion-imaging time had the best images. CONCLUSION The suitable parameters of the angiography lay the foundation of postmortem coronary angiography.
Animals ; Coronary Angiography/veterinary* ; Coronary Vessels/diagnostic imaging* ; Heart ; Imaging, Three-Dimensional/methods* ; In Vitro Techniques ; Multidetector Computed Tomography/veterinary* ; Predictive Value of Tests ; Sensitivity and Specificity ; Software ; Software Validation ; Swine

OBJECTIVETo discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis (AS) and the effect of combined anterior and posterior operation.

METHODSEighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel's score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach.

RESULTSThere were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up.

CONCLUSIONSThe study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.

Adult ; Cervical Vertebrae ; injuries ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Spinal Fractures ; surgery ; Spondylitis, Ankylosing ; complications

OBJECTIVETo analyze occurrence, prevention and treatment of the complications of thoracoscopic assisted spine surgery.

METHODSRetrospective review of 182 patients who underwent standard thoracoscopic technique or video-assisted thoracic surgical procedure from October 1998 to August 2004. The treatment of thoracic diseases included debridement, decompression with (or) reconstruction. The total number of complications were recorded, and its mechanism, prevention and treatment were analyzed.

RESULTSComplications occurred in 16 patients, 12 cases of perioperative complications included 3 patients suffered from pneumonia, 3 pulmonary atelectasis, 2 patients' lung injured by trocar, 1 patient obtained transient monoplegia, 2 suffered from transient intercostal nerve pain and 1 had superficial incision infection. Long-term complications occurred in 4 cases: spinal tuberculosis relapsed 2 cases (one who had diabetes obtained relapse in 8 months of post-operation and another relapsed with complex spinal tuberculosis in 4 weeks postoperation), 2 patients suffered from kyphosis deformity and pain.

CONCLUSIONSThe type and incidence of complications with thoracoscopic spine surgery mainly depend on indication, operation procedures and anesthesia, only by limit surgical indication, ameliorate technique, obey surgical principle and consummate perioperative treatment can we obtain mini-invasive effect by thoracoscopic assisted spine surgery.

Adolescent ; Adult ; Decompression, Surgical ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Diseases ; surgery ; Spinal Fusion ; adverse effects ; methods ; Thoracic Vertebrae ; surgery ; Thoracoscopy ; adverse effects

Objective To explore the relationship between human leukocyte antigen (HLA) DRB gene polymorphism and allergic reaction of anti-tuberculosis drugs in Chinese Han population.Methods HLA-DRB alleles in 35 patients with allergic reaction and 42 patients with no allergic reaction were analyzed using sequence-specific primer-polymerase chain reaction (PCR-SSP) method.Results The frequency of DR7 gene in allergy group was significantly higher than that in patients without allergic reaction group (10.0％ vs 1.2％,RR =10.25,P ＜0.05).Conclusion DR7 may be a susceptible gene for allergic reactions to anti-tuberculosis drugs.

Objective To explore the correlation between the genetic polymorphisms of organic anion-transporting polypeptide (OATP1B1),steady-state trough concentrations of rifampicin and the occurrence of hepatotoxicity induced by rifampicin.Methods Ninety tuberculosis (TB) patients were continuously administrated equal doses of rifampicin,34 cases developed drug-induced liver injury (DILI),while 56 had non drug-induced liver injury (non-DILI).Then trough concentrations of rifampicin in these subjects were determined by LC-MS/MS,and OATP1B1 388A ＞ G genotyping was obtained by polymerase chain reaction-restriction fragment length polymorphism (RFLP-PCR) methods.Finally,the correlations analysis were undertaken between the genetic polymorphisms of OATP1B1,steady-state trough concentrations of rifampicin and incidence of hepatotoxicity induced by rifampicin.Results There were 68 patients carrying wild-type genotypes and 22 carrying mutant genotypes in 90 subjects,with mutation rate of 24.44％.In which,mutant genotypes rates were 8.82％ (3 cases/34 cases) and 33.93％ (19 cases/56 cases) in DILI group and non-DILI group.Rifampicin trough concentration of patients with mutant genotypes was (5.63 ±4.16) ng· mL-1,3.43 times that of wild-type genotypes,which was (1.64 ±4.81) ng · mL-1.Likewise,concentration of rifampicin in non-DILI group was (3.82 ± 5.80) ng · mL-1,5.97 times that of DILI group,which was (0.64 ± 1.85) ng · mL-1.Mutation rate of OATP1B1 388A ＞ G in non-DILI group was 33.93％,3.85 times that in DILI group.The incidence of hepatotoxicity in patients carrying wild-type genotype was 45.59％,amounting to 3.34 times that of mutant genotypes.Conclusion Genetic polymorphisms of OATP1B1 may have significant impacts on steady-state trough concentration of rifampicin in Chinese patients and the occurrence of hepatotoxicity.

OBJECTIVETo evaluate the diagnosis and surgical treatment of obstructive azoospermia.

METHODSWe analyzed the clinical data of 56 cases of obstructive azoospermia, 43 of them with ejaculatory duct obstruction (EDO), and the other 13 suspected of epididymal obstruction. The diagnostic methods included semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, transrectal ultrasonography (TRUS), and vasography when necessary. The 43 patients with EDO were treated by transurethral resection of the ejaculatory duct (TURED), and 11 of the 13 cases of suspected epididymal obstruction were confirmed by scrotal exploration and underwent either bilateral or unilateral vasoepididymostomy. The patients were followed up for 3 -51 months for postoperative semen quality and impregnation.

RESULTSOf the 43 azoospermia patients with EDO treated by TURED, 36 (83.7%) showed improved semen parameters and 11 (25.6%) achieved pregnancies. Among the 11 cases of azoospermia with confirmed epididymal obstruction treated by vasoepididymostomy, 6 (54.5%) had sperm in the semen assay and 3 (27.3%) achieved pregnancies.

CONCLUSIONSemen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, TRUS and vasography are important diagnostic methods for obstructive azoospermia. TURED is effective for azoospermia with EDO, while vasoepididymostomy is preferable for the treatment of azoospermia with epididymal obstruction.

Adult ; Azoospermia ; etiology ; surgery ; Epididymis ; pathology ; surgery ; Humans ; Male ; Radiography ; Rectum ; diagnostic imaging ; Treatment Outcome ; Ultrasonography ; Vas Deferens ; diagnostic imaging ; surgery

OBJECTIVETo discuss the clinical effectiveness in treating thoracolumbar fractures adopting the rehabilitation exercise utilizing knee pads on the orthopedic traction bed.

METHODSFrom June 1996 to June 2006, we studied the clinical effectiveness of thoracolumbar fractures utilizing knee pads on the orthopedic traction bed for rehabilitation exercise. The cases surveyed total 209, 163 of which had full data. There were 98 males and 65 females with the age from 17 to 74 years (mean, 14.5 years). Consulting time after injury from 30 min to 7 days. Fracture site in T11 had 8 cases, in T12 24 cases, in L1 73 cases, in L2 33 cases, in L3 8 cases, in L4 3 cases, in T12 and L1 14 cases. Compression degree of vertebral anterior border: full compression had 1 case,more than 4/5 had 23, more than 2/3 had 67, more than 1/2 had 40, in 1/3 had 46.

RESULTSAmong them, 8 cases with legs paresis no recovery in nerval function or stopping recovery changed methods, and underwent surgical treatment. Others 155 cases were followed up from 2 to 12 years with an average of 3 years and 4 months. The average height of vertebral anterior borders of the 169 injured compressed had increased from 1.55 cm before treatment to 2.70 cm after treatment with an average of 1.15 cm. The height of the injured vertebral anterior borders had recovered from 50.5% (1.55/3.07) before treatment to 89.4% (2.70/3.02) after treatment. Kyphosis angle of the injured vertebral bodies had recovered from 13.25 degrees to -1.6 degrees in average. Twenty-three cases associated with dislocation basic reduction.

CONCLUSIONRehabilitation exercise using knee pads on the orthopedic traction bed can obtain satisfactory clinical effect in treating thoracolumbar fractures, the method is easy. At 3, 7, 10 days after treatment, the height of bed should be adjusted according X-ray.

Adolescent ; Adult ; Aged ; Exercise Therapy ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; injuries ; physiopathology ; surgery ; Male ; Middle Aged ; Orthopedic Equipment ; Recovery of Function ; Spinal Fractures ; physiopathology ; rehabilitation ; surgery ; Thoracic Vertebrae ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

Objective To find out the status of brick-tea type fluorosis in the epidemic areas.Methods Based on "Scheme for Epidemiological Brick-tea Type Fluorosis in Sichuan Province",ten counties were selected in Sichuan brick-tea areas and ten towns were selected in every county,then the epidemicologic survey was performed in children of 8～12 year-old and adults aged above 20 years old.Results 5044 children and 4053 adults were selected from brick-tea areas.The rates of dental fluorosis in children and adults were 55.69%(2809/5044)and 60.41%(4053/6709)respectively.The dental fluorosis was mainly of mild damage.The skeletal fluorosis found in X-ray film was 44.64%(167/1241)and in clinical examination,38.94%(3883/9973).The levels of urine fluoride in children and adults were 1.88 and 2.78 mg/L.The level of urine fluoride was not differenet among children of different age,but in adults it was higher in the elder than the younger.The level of fluoride in urine was related to the severeness of skeletal fluorosis(r=0.74).The detective rates of skeletal fluorosis in agricuIture,pasturing,and agriculture-pasturing areaswere 31.70%(1369/4318),50.04%(1228/2454),and 40.17%(1286/3201),respectively.The X-ray detecting rates of skeletal fluorosis in men and wonlen were 49.57%(229/462)and 41.72%(325/779) respectively(χ2=11.72,P＜0.05).Conclusion The prevalence of brick-tea type fluorosis is very serious in the regions studied.