Objective To observe the effect of Tangluotong Decoction(Decoctions of removing obstruction of meridians for treating diabetes)based on the principle of reinforcing kidney,activating blood and removing obstruction of meridians on the early diabetic nephropathy(DN)patients.Methods Totally 68 DN patients were randomized into two groups.In addition to the routine treatment for diabetes,the treatment group(38 patients)was administered Tangluotong Decoction while the control group(30 patients)was giv- en Lossartan Potassium Tablets.The clinical symptoms and signs and lab indices before and after treatment were observed.Results The comprehensive total effective rate of the treatment group was 89.47% while that of control group was 60.00%,the difference was significant(P

Medicine, Chinese Traditional

Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Fourty-five rats were randomly (random number) assigned to three groups,namely control group,model group,and rHuEPO group.ALI was induced by intravenous injection of LPS (6 mg/kg).The rHuEPO (5000 U/kg) was injected intravenously into rats 60 min before LPS challenge.The general status of rats was observed.Twelve hours after modeling,the rats were sacrificed and the tissue samples including lung tissue and blood were collected.PaO2,PaCO2,pH,the lung wet/dry weight ratio,plasma cytokines [interleukin (IL) IL-6 and tumor necrosis factor-alpha (TNF-α)],and inducible nitric oxide synthase (iNOS) were detected.Cytokines were assayed with ELISA method.Pathological changes of lung tissues were observed under light microscope and transmission electron microscopy.Results (1) Compared with the control group,PaO2,pH in the model group and in the rHuEPO group were significantly lower (P ＜ 0.05),and PaCO2 were significantly higher (P ＜ 0.05).Compared with the model group,PaO2,pH in the rHuEPO group were significantly higher (P ＜ 0.05),and PaCO2 were significantly lower (P ＜ 0.05).(2) Compared with the control group,the W/D weight ratio of lung tissues in the model group and the rHuEPO group was significantly higher (P ＜ 0.05).Compared with the model group,the W/D weight ratio of lung tissues in the rHuEPO group significantly lower (P ＜ 0.05).(3) The levels of TNF-o,IL-6 and iNOS in serum of rats in the control group were lower than those in the model group and the rHuEPO group (P ＜0.01).The serum levels of TNF-α,IL-6 and iNOS of rats in the rHuEPO group were significantly lower compared with the model group (P ＜ 0.01).(4) The light microscopy and the transmission electron microscopy showed the model group had histopathologic changes with acute diffuse lung injury manifested by intra-alveolar hemorrhage,exudate,inflammatory cells infiltration,Ⅰ type and Ⅱ type epithelial cell necrosis and detachment,and the pathological changes of lung tissue in the rHuEPO group were not as serious as those in the LPS group,showing only a little inflammatory cells infiltration of focal alveoli.Conclusions Recombinant human erythropoietin can inhibit the genesis of TNF-α,IL-6 and iNOS in serum,modifying the inflammatory response and providing protective effects against acute lung injury induced by sepsis.

OBJECTIVETo study modified ilioinguinal approach through the retrospective analysis on the surgical treatment of 63 patients with pelvic and acetabular fractures through anterior approach.

METHODSFrom January 2006 to January 2013, 63 patients with pelvic and acetabular fractures were treated with the ilioinguinal anterior approach, including 45 males and 18 females, ranging in age from 12 to 68 years old, with an average of (37.71 +/- 13.41) years old. All the patients were divided into two groups: standard ilioinguinal anterior approach group (group A) and modified ilioinguinal anterior approach group(group B). In group A, there were 26 males and 11 females, with an average age of (38.49 +/- 13.64) years old. In group B, there were 19 males and 7 females, with an average age of (36.62 +/- 13.29) years old. Intraoperative and postoperative indicators in group A and B were observed and compared, including operation incision exposure time (from skin incision to complete the ilioinguinal in front of three "windows"), the blood loss, incision close time and treatment effect of Majeed function score.

RESULTSCompared to group A, the incision exposure time of patients in group B was shorter, the blood loss (bleeding during exposure process) was less, and the close incision time was shorter, but the treatment effect of Majeed function score had no significant differences between two groups. All the patients were followed up, and the during ranged from 3 to 36 months, with an average of (18.6 +/- 9.2) months. According to Matta standard assessment reduction of pelvic and acetabular fracture, there were 28 patients got an excellent result, 8 good, and 1 fair in the group A; and 20 patients got an excellent result, 5 good, and 1 fair in the group B. According to Majeed function score for hip function, 20 patients got a satisfactory result, 12 good,4 fair and 1 poor in group A, and the mean score was 82.51 +/- 9.72; and 13 patients got an satisfactory result, 10 good, 3 fair and 0 poor in group B, and the mean score was 80.54 +/- 10.79.

CONCLUSIONThe modified approach has several advantages as follows: providing a good surgical exposure; preventing from the injury of femoral nerve, femoral artery and vein under the inguinal ligament; not needing to open the inguinal canal, which can avoid the occurrence of inguinal hernia, reduce operation prodedures and shorten operation time.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective - - To analyze the prevalence and influencing factors of multi site work related musculoskeletal disorders （ ） Methods WMSDs in surgeons. A total of 102 surgeons from four hospitals were selected as study subjects by convenient sampling method. The Chinese version of Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of ， Results WMSDs in the past one year the related individuals and occupational factors. The total prevalence of WMSDs among （ ）， （ ） （ ） surgeons was 54.9%. The top three sites were neck 48.0% lower back 35.3% and shoulder 32.4% . The prevalence of （ vs ，P ） WMSDs in multiple sites was higher than that in a single site 43.1% 11.8% <0.01 . Multivariate logistic regression ， ， analysis showed that surgeons who smoked were tired at work and had a bent back had a higher risk of developing WMSDs ［ （ - ）， （ - ）， （ - ）， P ］ odds ratios and 95% confidence intervals were 3.66 1.41 9.46 8.33 2.15 32.20 and 18.74 2.14 166.77 all <0.01 Conclusion - after excluding the influence of confounding factors. The prevalence rate of multi site WMSDs among surgeons is ， high and the influencing factors include bad living habits and occupational factors such as working load and working posture.

Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute kidney injury (AKI).Methods A total of 260 healthy male Sprague-Dawley rats (250-300 g) were randomly divided into 6 groups:normal control group,sham group,CLP model group,the large dose rHuEPO (5000 U/kg)group,the middle dose rHuEPO (1000 U/kg) group,and the small dose rHuEPO (500 U/kg) group.The rat models of sepsis were established by CLP.In treatment groups,rats were treated with rHuEPO through caudalis injection after CLP surgery.Each group was divided into 2-,6-,12-,24-,36-hour subgroups with 10 rats.Rats were sacrificed and the tissue samples including kidney and blood samples were collected.The kidney function,plasma cytokines [interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α)],kidney injury moleclue 1 (KIM-1) and inducible nitric oxide synthase (iNOS)were measured.Cytokines were determined by ELISA method.The expression of nuclear factor-kappaB (NF-κB) protein in kidneys were detected by immnunohistochemistry method.Pathological changes of kidney tissues were observed by light and transmission electron microscopy for cytokine content and apoptosis.Results Compared with CLP model group,renal function,the levels of TNF-α,IL-6,KIM-1 and iNOS in serum,the expression of NF-κB,significantly decresed in large dose rHuEPO group (all P ＜ 0.05).rHuEPO also lessened the histological changes in large dose group.rHuEPO did not lessen the histological changes in others.Conclusion rHuEPO can inhibit the levels of TNF-α,IL-6 and iNOS in serum,thus modify the inflammatory response and provide protective effects against acute kidney injury induced by sepsis.

Objective To evaluate the clinical value of 131 Ⅰ SPECT/CT in the differentiation of indeterminate 131Ⅰ uptake on planer whole body scan (WBS) for patients with DTC after 131Ⅰ treatment. Methods Fifty-six DTC patients ( male: 19, female: 37, mean age: 45 ± 15 years, ranging from 20 to 85 years) underwent 131Ⅰ treatment. 131Ⅰ WBS was performed five days after 131 Ⅰ treatment, followed by regional 131Ⅰ SPECT/CT for the indeterminate foci with abnormal uptake on 131Ⅰ WBS. The diagnostic difference of the two imaging modalities was compared by x2 test. Results There were 288 foci with abnormal uptake on 131 Ⅰ WBS, including 108 indeterminate foci (37.5%). Subsequent 131Ⅰ SPECT/CT identified 27 foci as DTC metastases (25.0%) and 71 foci as non-metastases such as benign lesions at nose, oral cavity, salivary gland, maxillary cyst, thyroid remnant, thymus, gallbladder, gastrointestinal tract, and uterus, or non-specific uptake of body contaminations (65.7%). However, the remaining 10 foci (9.3%) remained indeterminate on 131 Ⅰ SPECT/CT imaging. The diagnostic accuracy of 131 Ⅰ SPECT/CT was significantly higher than that of 131Ⅰ WBS (x2 = 102.35, P＜0. 01). Conclusion 131Ⅰ SPECT/CT could significantly improve the diagnostic accuracy for the differentiation of indeterminate foci with abnormal uptake on 131Ⅰ WBS.

Objective To explorethe effect of Bailingcapsule on epithelial-mesenchymal transition(EMT) inrats withadenine-in-duced tubulointerstitial fibrosis .Methods Tubulointerstitial fibrosis ani mal models were established and SDrats were dividedinto mo-del group (n=30) ,treatment group (n=30) andcontrol group(n=30) ,randomly .Experi mental rats were harvested at 7 w,12 w,17 wafter onset of experi ment and functional evaluations were performed. Histology ,i mmunohistology were examined to investigateboth histolopathology changes and the expression of bone morphogenic protein-7 (BMP-7) ,transforming growth factor-?1(TGF-?1)and a-smooth muscle actin (?-SMA) in kidneys at three ti me points mentioned above ,respectively .Results Compared with controlgroup ,24 h urinary proteinin model grouplost increasingly and significantly difference appeared at three ti me points relative to controlgroup(P0 .05) rel-ative to control group.There was significant difference at 12 wand 17 w(P

Objective To analyze the imaging findings and misdiagnosis of intraductal papillary mucinous neoplasm (IPMN),to improve diagnosis level and decrease misdiagnosis rate.Methods The images of 130 patients were suspicion or diagnosis of IPMN, and the other pancreatic lesions but confirmed IPMN by pathology.Two radiologists collected materials, analyzed the reasons of misdiagnosis, and found out countermeasures.Results A total of 130 patients confirmed by pathology were available for analysis, in which there were 105 (80.7%) of IPMN, and 25 (19.2%) of other pancreatic lesions.The most misdiagnosed patients were between IPMN and chronic pancreatitis(CP),serous cystadenoma(SCN).All patients were divided into mild to moderate group and severe to infiltrating carcinoma group based on pathologic grades.There was significant difference between two groups in cystic diameter, wall nodule, separation and dilation, the diameter of main duct, and intra-or extrahepatic biliary tract(P<0.05).The most common causes of misdiagnosis included that the radiologists didn't combined with the patient's clinical features,and didn't reconstruct images or perform MRCP scan when the relationship between the lesions and the pancreatic duct was unclear.Conclusion It is important that the radiologists need to combine with the patient's clinical features, clear the relationship between the lesions and the pancreatic duct, and fully master imaging findings.The recurrent pancreatitis maybe result from IPMN, and IPMN for a long time would lead to CP.

Objective To establish a MRI grading diagnostic model for chronic pancreatitis (CP) to acquire better combination for CP diagnosis and improve the diagnostic ability of CP grading.Methods To collecte the data of 68 CP patients who were clinically diagnosed and 23 health volunteers from Dec 2012 to Oct 2014.There were 23 mild CP, 14 moderate CP and 31 severe CP according to Cambridge classification.3.0 T MRI data were analyzed, and 14 features were extracted to compare the MRI features among groups.The single ordinal regression analysis was conducted on the variables with significant difference between groups, and the collinearity was diagnosed.The factor analysis was used for multicollinearity.The multiple ordinal logistic regression was finally conducted to establish the regression model.Results There was no significant difference between control groups and CP groups on pancreas divisum (X14), but significant differences were found in other 13 features (P<0.05).Single ordinal regression analysis of 13 features showed that all features except pancreatic parenchymal bubble (X12) were significantly correlated with CP grading diagnosis(P<0.05).The effect of multicollinearity was validated among 9 continuous variables.Three common factors were identified, including F1(X3、X4、X5、X9、X8), F2(X7、X6) and F3 (X1、X2) which represented the exocrine function, the features of main pancreatic ducts and pancreatic parenchyma, respectively.Six features were implemented into the multi Logistic regression model, which included F1, F2, F3, X10 (the visualizations of branch pancreatic duct after secretin stimulation), X11 (pancreatic shape) and X13 (the filling defects of main pancreatic duct).Finally, the most appropriate regression model was gotten, which was the scale model of the probit link function.The model′s diagnostic accuracy for normal, mild CP, moderate CP, severe CP and total CP was 96.65%,100%, 71.42%,100% and 94.50%, respectively.Conclusions The ordinal logistic regression model proposed in this study may accurately predict the CP grades and can offer valuable references for clinic diagnosis and therapy of CP.