Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.

Objective To investigate the effect ofbuflomedil hydrochlorde on regional cerebral blood flow in different subtypes of schizophrenia.Methods Two hundred and eighty-six patient met the diagnostic criteria of CCMD-3 for schizophrenia,admitted to our hospital from February 2007 to February 2009,were chosen in our study; patients of type Ⅰ (n=86),type Ⅱ (n=63) and type Ⅲ (n=137)were randomly divided into treatment group of type Ⅰ (n=46),placebo treatment group of type Ⅰ (n=40),treatment group of type Ⅱ (n=34),placebo treatment group of type Ⅱ (n=29),treatment group of type Ⅲ(n=72) and placebo treatment group of type Ⅲ (n=65).Patients from the treatment groups were treated with antipsychotics with buflomedil hydrochloride and those from placebo treatment groups were given antipsychotics with saline for 4 weeks.On the 1st day and at the end of the 4th week of treatment,cerebral blood flows of bilateral anterior cerebral artery,middle cerebral artery,posterior cerebral artery,vertebral artery and basilar arterywere were measured by transcranial Doppler (TCD).Results No statistically significant difference of cerebral blood flow was noted between the two groups of type Ⅰ before/after treatment,neither between before and after treatment in one of the groups (P＞0.05).For type Ⅱ schizophrenia,no statistically significant difference of cerebral blood flow was noted between the two groups on the 1st day of treatment (P＞0.05); however,at the end of 4th week of treatment,cerebral blood flow in the bilateral anterior cerebral artery,middle cerebral artery,posterior cerebral artery blood of the treatment group were significant greater than that in the placebo treatment group (P＜0.05); the cerebral blood flow in the bilateral anterior cerebral artery,middle cerebral artery,posterior cerebral artery blood of the treatment group at the end of 4th week of treatment was significantly higher than that on the 1 st day of treatment (P＜0.05),while no significant difference was noted in the placebo treatment group (P＞0.05).For type Ⅲ schizophrenia,at the end of 4th week of treatment,the cerebral blood flow in the treatment group in the left anterior cerebral artery,the left middle cerebral artery and right middle cerebral artery were significant greater than that in the placebo treatment group (P＜0.05); and that of the bilateral anterior cerebral artery and middle cerebral artery in the treatment group at the end of 4th week of treatment was significantly greater than that on the 1st day of treatment (P＜0.05).Conclusions Different subtypes of schizophrenia enjoys different cerebral blood flows:most significant decline in cerebral blood flow and largest number of cerebral arteries of type Ⅱ schizophrenia are noted,followed by type Ⅲ schizophrenia;cerebral blood flow of schizophrenia maybe have an order to decline and the left middle cerebral artery maybe the first; the changes of cerebral blood flow between before and after treatment show that the decline of cerebral blood flow can be inverted with drugs.

Objective To investigate the expression of vascular endothelial growth factor (VEGF) and aquaporin 4 (AQP4) in giiomas and brain metastases, and explore the role of VEGF and AQP4 in the histopathology and formation of peritumoral edema of primary and metastatic gliomas. Methods Immunohistocbemical method was used to examine the protein expression of VEGF and AQP4 in 73 paraffin-embeded, pathologically confirmed glioma and 15 metastatic tumor specimens collected between 1999 and 2001. Eight normal brain tissue specimens were used as the control. Results VEGF protein was not detected in normal brain tissues. VEGF expression was detected in gliomas and the expression level increased obviously along with the histological grade of the tumor. Significant differences were found in VEGF expression between malignant and low-grade gliomas, between low-grade gliomas and normal brain tissues, and between intracranial metastatic tumors and normal brain tissues and low-grade gliomas (P<0.05), but not between intracranial metastatic tumors and malignant gliomas (P>0.05). AQP4 protein expression was found in all the collected samples, and its expression differed significantly between normal brain tissues and malignant gliomas or intracranial metastatic tumors, and also between low-grade gliomas and malignant gliomas or intracranial metastatic tumors (P<0.05), but not between normal brain tissues and low-grade gliomas or between intracranialmetastatic tumors and malignant gliomas (P>0.05). VEGF protein expression showed a significant positive correlation to AQP4 protein expression (r=0.516, P<0.05). Conclusion As important molecular biological factors, VEGF and AQP4 participate in the formation peritumoral brain edema of gliomas and exhibit a synergie effect in this process.

Objective To demonstrate the efficiency and safety of the modified reverse controlled antegrade and retrograde subintimal tracking(CART)technique for chronic total occlusion(CTO)recanalization.Methods Thirteen patients with CTO underwent this modified reverse CART technique.Based on the traditional reverse CART,the technology advocated the use of antegrade guidewire Knuckle technology to promote access to the subintimal space.With the use of a strong penetrating and well controllable retrograde guidewire,balloon was inflated in the CTO lesion in favor of advancing the retrograde guidewire through the lesion to reach the proximal true lumen.Results The occlusion site was located in the RCA in 10 patients and in the LAD in 3 patients.Among the 13 lesions,2 had J-CTO score = 1,4 had J-CTO score = 2,6 had J-CTO score = 3,and 1 had J-CTO score=4.Nine cases were considered as the Werner`s Collateral Connection grade 1 and other 4 cases were grade 2.All 13 cases had achieved technical success.1 case needed pericardiocentesis due to collateral branch perforation.Conclusions CTO lesions can be efficiently and safely recanalized using this modified reverse CART technique.

OBJECTIVETo study the clinical therapeutic effects and safety of Fufang Biejia Ruangan tablet (FBRt) in patients with chronic hepatitis B complicated with hepatic fibrosis.

METHODSTotally 420 patients were randomly divided into two groups, FBRt group (300 cases) were treated with Fufang Biejia Ruangan tablets and control group (120 cases) were treated with He Luo Shu Gan capsule, the patients in both groups were treated for 6 months.

RESULTSThe cure rate and total effective rate of FBRt group were significantly higher than those of control group (55.67 percent and 81.67 percent vs. 15.8 percent and 60.00 percent, P less than 0.01).

CONCLUSIONFufang Biejia Ruangan tablet could alleviate clinical symptoms and hepatic fibrosis. Fufang Biejia Ruangan tablet is effective and safe in treatment of patients with chronic hepatitis B complicated with liver fibrosis.

Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; pathology ; Humans ; Liver ; pathology ; physiopathology ; Liver Cirrhosis ; drug therapy ; etiology ; pathology ; Medicine, Chinese Traditional ; Middle Aged ; Tablets

BACKGROUND:Insulin analogues have been extensively applied in the treatment of diabetes mellitus.Insulin glargine has a higher affinity for insulin like growth factor 1 receptor compared with human insulin.Further research is needed to ensure whether insulin and its analogues exert same effects on fracture healing in type 2 diabetes mellitus.OBJECTIVE:To observe the osteocalcin expression and callus formation in the healing of fracture in type 2 diabetic rats induced by human insulin and insulin glargine,to observe the difference between two treatment methods,and to explore the related mechanisms.METHODS:Sixty-four Sprague-Dawley rats were randomly assigned into human insulin group (group A),insulin glargine group (group B),diabetes mellitus group (group C) and control group (group D).Rats in the groups A,B and C were fed with high-sugar and high-fat diet for 4 weeks followed by intraperitoneal injection of small-dosage streptozotocin twice,to establish the rat models of type 2 diabetes mellitus.After the right tibia of each rat was broken,insulin glargine and Novolin 30R were used in the groups A and B,respectively.Fracture healing was observed on X-ray,callus formation and number of osteoblasts were observed by microscope,and serum level of osteocalcin was measured by ELISA method at 1,2,4,and 6 weeks after modeling.RESULTS AND CONCLUSION:X-ray results revealed better fracture healing in the groups A,B and D than the group C.Osteoblast proliferation in callus was significantly better in the groups A,B and D than in the group C.Serum level of osteocalcin in each group was on the rise,which was significantly higher in the groups A,B and D than the group C (P ＜ 0.05),but had no significant difference among groups A,B and D (P ＞ 0.05).In summary,insulin glargine can increase the serum level of osteocalcin,accelerate the callus formation,and improve the healing of fracture in type 2 diabetic rats.Furthermore,there is no significant difference in the therapeutic efficacy between insulin glargine and human insulin.

Objective·To investigate the risk factors for gestational diabetes mellitus (GDM) among multiparae. Methods?·?Women who had two consecutive pregnancies records in the International Peace Maternity and Child Health Hospital from January 2012 to January 2017 were included into this study. The case group (116 cases) and control group (464 cases) were matched at the ratio of 1:4 according to the pre-pregnancy age in index pregnancy. Clinical characteristics, biochemical parameters including oral glucose tolerance test (OGTT) and lipid profiles were took into consideration by virtue of their medical records. Multivariate Logistic regression analysis was used to compute the adjusted odds ratio (aOR) and 95%CI so as to identify the risk factors. Results?·?Compared with the control group, the case group was associated with greater body mass index (BMI) change between pregnancies (aOR=1.35, 95%?CI=1.07-1.69), greater postprandial 1 h glucose load (aOR=1.99, 95%?CI=1.55-2.55) and 2 h glucose load (aOR=2.02, 95%?CI=1.51-2.70) at OGTT in index pregnancy, and greater first-trimester fasting plasma glucose (aOR=1.96, 95%?CI=1.16-3.32), total cholesterol (aOR=1.37, 95%?CI=1.06-1.77) and triacylglycerol (aOR=1.53, 95%?CI=1.10-2.14) in subsequent pregnancy. Conclusion?·?The elevated BMI change between pregnancies, the abnormal glucose and lipid profiles persisting from index to subsequent pregnancy lead to the occurrence of GDM.

OBJECTIVETo investigate the human immunodeficiency virus (HIV) and syphilis incidence rates as well as the retention rate in a cohort with 6-month follow-up study among female sex workers (FSWs).

METHODSFrom December, 2004, to January, 2005, a community-based baseline survey was conducted to recruit 343 FSWs for a prospective cohort study in Xichang county of Sichuan province, China. Follow-up visits were conducted at 6 months to analyze risk factors associated with cohort retention for subjects' baseline sociodemographic and sexual behavioral characteristics. Blood specimens were also collected to test antibodies against HIV and syphilis.

RESULTSDuring the 6-month follow-up period, HIV and syphilis incidence appeared to be 1.00 per 100 person-years and 6.23 per 100 person-years, respectively. The rate of retention in the cohort was 53.6% (184/343). Results from multivariate logistic regression model showed that factors were significantly associated with cohort retention including people with minority ethnic background (OR = 0.36; 95% CI: 0.18-0.74), people having participated in AIDS prevention program (OR = 1.83; 95% CI: 1.17-2.86) or being clients in the last 6 months > or = 50 (OR = 1.75; 95% CI: 1.11-2.77) and having changed living/working place (OR = 0.56; 95% CI: 0.33-0.94).

CONCLUSIONThe results of this study showed that the syphilis incidence and unprotected sex behavior were high among local FSWs. People belonged to Han nationality, having participated in AIDS prevention program and having a steady living/working place were associated with cohort retention at 6-month follow-up study among FSWs, respectively.

China ; epidemiology ; Female ; Follow-Up Studies ; HIV Infections ; epidemiology ; Humans ; Incidence ; Risk Factors ; Sex Work ; Sexual Behavior ; Substance-Related Disorders ; Syphilis ; epidemiology

To investigate the influence of G-CSF mobilization on functions of donor T lymphocyte subpopulation and acute graft-versus-host disease, peripheral blood samples of 20 healthy donors were collected before and after G-CSF mobilization. The whole blood was diluted with IMDM in ratio of 1:1 and then incubated with PMA + ionomycin + monensin at 37 degrees C, 5% CO2 for 4 hours. After being mobilized and stained, the IL-4, IFN-gamma and IL-2 positive cells were counted with three-color flow cytometry. The results showed that before G-CSF mobilization, the percentages of donor's CD3(+)IFN-gamma(+), CD4(+)IFN-gamma(+), CD8(+)IFN-gamma(+) T cells were 3.2% (0% - 45.9%), 1.3% (0% - 23.8%) and 1.5% (0% - 22.2%) respectively. The percentage of above mentioned cells in donor increased to 19.2% (0% - 53.9%), 9.5% (0% - 49.5%), 7.5% (0% - 38.1%) respectively after G-CSF mobilization. The IL-2 positive CD3(+), CD4(+) and CD8(+) T cell percentage in pre-G-CSF mobilized donors was 1.5% (0% - 31%), 0.8% (0% - 30.0%) and 0% (0% - 5.3%) respectively and subsequently increased to 25.7% (0% - 51%), 19.8% (0% - 39.7%), 4.6% (0% - 20.9%) respectively after G-CSF mobilization. The IL-4 positive T subpopulation did not increased significantly after G-CSF mobilization. In the early stage after peripheral blood stem cell transplantation, donor's Tc1 percentage in aGVHD group was significantly higher than that in non-aGVHD group. The morbidity of severe aGVHD in high Tc2 percentage group was significantly lower than that in low Tc2 percentage group. It is concluded that the donor's type I T cells increase after G-CSF mobilization, the Tc1 percentage of G-CSF mobilized donor is correlated with the occurrence of aGVHD in the early stage after HSCT, the percentage of Tc2 in donor is negatively correlated with aGVHD morbidity in recipients.
Adolescent ; Adult ; Female ; Graft vs Host Disease ; etiology ; Granulocyte Colony-Stimulating Factor ; adverse effects ; Hematopoietic Stem Cell Mobilization ; adverse effects ; methods ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; therapy ; Leukemia, Myeloid, Acute ; therapy ; Male ; Middle Aged ; Recombinant Proteins ; T-Lymphocyte Subsets ; immunology ; T-Lymphocytes ; immunology

Objective To evaluate the feasibility and efficacy of Guidezilla TM guide extension catheter in retrograde technique for chronic total occlusion (CTO) recanalization. Methods We retrospectively collected 119 CTO cases from the 2nd Cardiology Department of Guangdong General Hospital who had received retrograde percutaneous coronary intervention( PCI). The Guidezilla TMguide extension catheters were applied in 39 cases from October 2015 to November 2016. 80 CTO cases without using the Guidezilla TMguide extension catheter during PCI admitted between January 2015 and October 2015 were collected as the control. Results The overal success rate of the 2 group was 84.0%. The group using the Guidezilla TMguide extension catheter had a higher success rate(100% vs.76.2%,P<0.05).The baseline clinical characteristics of the two groups showed no statistical diff erence. In terms of CTO crossing diffi culty by J-CTO score, patient in the Guidezilla TMguide extension catheter group had higher percentage of diffi cult lesions(35.9% vs.15.0%,P<0.001)and very difficult lesions(61.5% vs.32.5%,P<0.001).Patients in the Guidezilla TMguide extension catheter group had more longer lesions(89.7% vs.72.5%,P=0.035),blunt proximal occlusion(53.8% vs.32.5%,P=0.030)and tortuosity lesions(84.6% vs.63.8%,P=0.020). More cases in the control group needed a second operation(63.8% vs.25.6%,P<0.001)and more ostial/bifurcation lesions(62.5% vs.30.8%,P=0.002).All cases had no target vessel revascularization or in-hospital death. Conclusions Guidezilla TMguide extension catheter is convenient and safe for complicated CTO retrograde PCI.