Objective To investigate the effect of hot compress with traditional Chinese herbs with wine and vinegar on lumbago after cesarean section. Methods Ninety patients with lumbago after cesarean section were divided into the control group and the observation group equally according to their admission number. Both groups were cured by the injection at the pressure pain point, the observation group by hot compress of traditional Chinese herbs of Reyanbao with wine and vinegar. The treatment effect between both groups were observed. Results The effective rates of the experiment group and the control group were 93.3%and 68.9%, respectively. The difference was statistically significant (χ2=12.433, P<0.05). Conclusions Based on injection on the pressure pain point, lumbago after cesarean section can be effectively relieved with the extra treatment by hot compress with traditional Chinese herb of Reyanbao with wine and vinegar. The treatment is simple and safe and worthy of being applied clinically.

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the effects of total flavonoids of propolis (TFP) on apoptosis of myocardial cells of chronic heart failure and its possible mechanism in rats.

METHODSSix male SD rats were randomly selected as normal control group, the remaining rats were made as chronic heart failure (CHF) model by intraperitoneal injection of adriamycin. The rats in the successful model were randomly divided into five groups (n = 6): CHF group, total flavonoids of propolis low dose group (LD group), total flavonoids of propolis middle dose group (MD group), total flavonoids of propolis high dose group (HD group), digoxin group (DIG group). After six week treatment, cardiac function indexes of rats were recorded by signal acquisition system; brain natriuretic peptide (BNP), cardiac troponin I (cTnI), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) content in plasma were detected; Myocardial morphological changes and collagen fiber hyperplasia by HE and Masson staining were observed; Myocardial apoptosis was detected with TUNEL method and protein connexin 43(P-Cx43) expression was detected by Western blot method.

RESULTSCompared with NC group, left ventricular systolic pressure(LVSP) and maximal rise/fall velocity of left ventriculad pressure (± dP/dt(max)) absolute value in CHF group were significantly lowered (P < 0.01) while left ventricular end diastolic pressure (LVEDP) was increased significantly (P < 0.01); Contents of plasma BNP, cTnI, TNF-α and IL-6 in the CHF group were significantly improved (P < 0.01). Compared with CHF group, LVSP, ± dP/dt(max) absolute value in MD and HD groups were increased (P < 0.05), and LVEDP was significantly lowered (P < 0.01); LVEDP in LD group was significantly lowered (P < 0.01), changes in LVSP and ± dp/dt(max) absolue value were not obvious (P > 0.05). BNP, cTnI, TNF-α and IL-6 contents in MD and HD groups were significantly reduced (P < 0.01), but those plasma indicator changes were not obvious in LD group (P > 0.05). Western blot showed that P-Cx43 expression in CHF group was significantly higher than that in NC group (P < 0.01) and that in all TFP treatment groups it was decreased compared with CHF group (P < 0.05, P < 0.01), among which pairwise comparisons also showed differences (P < 0.05), myocardial apoptosis index (%)(22.62 ± 3.39) in CHF group was higher than that in NC group( 1.12 ± 0.24) (P < 0.01); compared with CHF group, the apoptosis index of myocardial cells (%) in LD,MD and HD groups, (15.79 + 2.8), (9.28 + 2.1) and (4.73 + 1.14) respectively, were significantly lower than those in the CHF group( P < 0.01). The expression level of P-Cx43 positively correlated with the apoptotic index (r = 0. 861, P < 0.01).

CONCLUSIONTotal flavonaids of propolis have inhibitory effect on apoptosis of myocardial cells of chronic heart failure induced by adriamycin in rats, and the mechanism may be closely related to the regulation of Cx43 expression, especially the regulatory phosphorylation status.

Animals ; Apoptosis ; Chronic Disease ; Connexin 43 ; metabolism ; Disease Models, Animal ; Doxorubicin ; adverse effects ; Flavonoids ; pharmacology ; Heart Failure ; drug therapy ; Interleukin-6 ; blood ; Male ; Myocardium ; pathology ; Myocytes, Cardiac ; drug effects ; Natriuretic Peptide, Brain ; blood ; Phosphorylation ; Propolis ; chemistry ; Rats ; Rats, Sprague-Dawley ; Troponin I ; blood ; Tumor Necrosis Factor-alpha ; blood

AIM To observe the clinical efficacy of Maixuekang Capsules (hirudin) combined with female progestational hormone treating blood-stagnated cryptogenic hypomenorrhea and their mechanism of action.METHODS Ninty eligible patients were randomly and equally divided into treatment group (Maixuekang Capsules combine with female progestational hormone) and control group (female progestational hormone),treated for three menstrual cycles,the menstrual blood volume,blood D-dimer,maximum platelet aggregation rate,the thickness of endometrium,spiral artery blood flow peak systolic velocity (PSV),resistance index (RI) and pulsatility index (PI) were recorded during the three months period.RESULTS The menstrual blood volume of the two groups were all increased post-treatments (P ＜ 0.05),the treatment group was superior to the control group (P ＜ 0.05);blood D-dimer and maximum platelet aggregation rate of the treatment group had reduced post-treatments (P ＜ 0.05),there was no difference in the two values of the control group between post-treatment and pre-treatment (P ＞ 0.05);the thickness of endometrium of the two groups were both increased after the treatment (P ＜ 0.05),while there was no remarkable statistical difference between the two groups (P ＞ 0.05);RI in the treatment group had remarkable reduction post-treatments (P ＜ 0.05),but there was no remarkable difference of RI in the control group (P ＞ 0.05);there was no statistical difference of PSV and PI in both groups before and after the treatment (P ＞ 0.05).CONCLUSION The combination treatment of Maixuekang Capsules and female progestational hormone can obviously increase menstrual blood volume,improve uterine blood perfusion and endometrial microcirculation.It has more advantages than use hormones alone.

OBJECTIVETo realize the clinical features of autoimmune hepatitis-primary biliary cirrhosis (AIH+PBC) overlap syndrome.

METHODSWe analyzed and compared the biochemistry, autoimmune antibodies, and liver biopsy results of 129 autoimmune hepatic disease cases retrospectively, using the international criteria to see which could be diagnosed as AIH/PBC overlap syndrome.

RESULTSOur 35 AIH+PBC overlap syndrome patients were mainly women, with a sex ratio of 1 female: 10 male, and a median age of 50.79+/-11.27 (20 to 70 years old). They had AIH characteristics such as flare of ALT, AST and elevated immunoglobulin G (IgG), gamma-immunoglobulin. There were also antinuclear antibodies (74.3%); moderate or severe periportal or periseptal lymphocytic infiltration, piecemeal necrosis, and florid bile duct lesions, high serum levels of ALP, presence of mitochondrial antibodies (68.6%) and M2 antibodies (45.7%), and features of PBC.

CONCLUSIONSAIH+PBC overlap syndrome is not rare. It should be diagnosed in time and to find effective treatments for it.

Adult ; Autoantibodies ; blood ; Cholagogues and Choleretics ; therapeutic use ; Female ; Hepatitis, Autoimmune ; complications ; diagnosis ; drug therapy ; Humans ; Immunoglobulin G ; blood ; Liver Cirrhosis, Biliary ; complications ; diagnosis ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Ursodeoxycholic Acid ; therapeutic use

BACKGROUNDTo study the clinical features and more reasonable typing criteria for patients with chronic severe hepatitis and decompensated liver function.

METHODSData of 106 cases of decompensated cirrhosis, 124 cases of chronic liver failure and 100 cases of chronic liver failure (chronic liver failure group I, CLF I) with decompensated cirrhosis (chronic liver failure group II, CLF II) were analyzed retrospectively.

RESULTS(1) The ages were youngest in chronic liver failure group I (about 30 years), and the oldest in decompensated cirrhosis group (about 50 years). (2) There were significant differences in albumin, globulin, ALT, AST, protruding activity, blood glucose, blood lipid and cholinesterase among the three groups. (3) There was no significant difference in upper digestive tract bleeding and hepatorenal syndrome, on the other hand, there was significant difference in ascites and hepatic encephalopathy. (4) The prognosis of the patients in decompensated cirrhosis group was better than that of chronic liver failure group I and chronic liver failure group II.

CONCLUSIONThe clinical feature and prognosis in three groups were different, so, it is suggested that chronic severe liver disease be divided into 2 types: one is chronic severe liver disease type I, which is associated with chronic hepatitis, and the other is chronic severe liver disease type II, which is associated with cirrhosis, and the typing criteria for decompensated cirrhosis remains unchanged.

Adult ; Diagnosis, Differential ; Female ; Hepatitis, Chronic ; classification ; complications ; diagnosis ; Humans ; Liver Cirrhosis ; classification ; complications ; diagnosis ; Liver Failure ; etiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.

METHODSFrom May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.

RESULTSAll incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.

CONCLUSIONThe application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Adolescent ; Adult ; Carpal Joints ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Hamate Bone ; injuries ; surgery ; Humans ; Male ; Metacarpal Bones ; injuries ; surgery ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Sutures ; utilization ; Young Adult

OBJECTIVETo investigate c-myc proto-oncogene expression and the relationship of PCNA protein expression of extrahepatic vascular smooth muscle cell in patients with portal hypertension and normal vessels.

METHODSRT-PCR was used to demonstrate the expression of c-myc mRNA and immuno-chemistry strain was performed to detect the expression of PCNA protein in splenic veins of 28 patients with portal hypertension and 12 normal vessels.

RESULTSThe straining of PCNA protein was (29.8 +/- 4.7)% in splenic veins with portal hypertension, Normal vessels did not detect PCNA protein expression (P < 0.01); RT-PCR showed that the expression of c-myc mRNA in PCNA-positive control and in negative control of splenic veins with portal hypertension were (7.61 +/- 1.04)% and (3.82 +/- 0.92)%, respectively. There ws different between two groups (P < 0.01) and significant different (P < 0.01) when compared with (1.01 +/- 0.21)% in normal vessels.

CONCLUSIONSThe c-myc was immediate-early gene when it modulated proliferation of vascular smooth muscle cell. Hemodynamic disturbance of portal vein system activate the proto-oncogene of smooth muscle cells in splenic vein of patients with portal hypertension, promoting the proliferation, migrating and phenotypic change and resulting in vascular remodelling of splenic veins.

Adult ; Aged ; Cell Proliferation ; Female ; Gene Expression ; Genes, myc ; genetics ; Humans ; Hypertension, Portal ; genetics ; pathology ; In Vitro Techniques ; Male ; Middle Aged ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Myocytes, Smooth Muscle ; cytology ; Proliferating Cell Nuclear Antigen ; metabolism ; RNA, Messenger ; genetics ; Splenic Vein ; cytology ; metabolism

OBJECTIVETo investigate if the interaction between TGF-beta1/Smad pathway and ERK pathway in vascular smooth muscle cells exists.

METHODSThe rat arota was removed. The primary VSMC were isolated and cultured in vitro, then the VSMC were divided into four groups: (1) control group, (2) (TGF-beta1 group, (3) ERK blocking agent group, (4) TGF-beta1 + ERK blocking agent group. The expression of Smad2/3, ERK1/2 proteins, the content of phosphorylated ERK1/2 and Smad2/3 proteins were detected by Western blot, and the expression of Smad2/3 mRNA was detected by reverse transcription-polymerase chain reaction(RT-PCR) .

RESULTS(1) In contrast to control group, the content of phosphorylated Smad2/3 and phosphorylated ERK1/2 proteins in TGF-beta1 group was increased (P < 0.05), that in ERK blocking agent group was decreased (P < 0.05). There was no difference between control group and TGF-beta1 + ERK blocking agent group. Compared with TGF-beta1 group, the contents of phosphorylated Smad2/3 and phosphorylated ERK1/2 proteins in TGF-beta1 + ERK blocking agent group was decreased (P < 0.05). There was no difference in the expression of Smad2/3 and ERK1/2 proteins among different groups. (2) There were no differences in expression of Smad2 and Smad3 mRNA among different groups.

CONCLUSION(1) TGF-beta1 can induce Smad2/3 proteins to be phosphorylated dependent on the activated ERK pathway. (2) ERK pathway does not effect the expression of Smad2/3 at the level of protein and mRNA.

Animals ; Aorta ; cytology ; Cells, Cultured ; Female ; MAP Kinase Signaling System ; physiology ; Male ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Muscle, Smooth, Vascular ; cytology ; physiology ; Myocytes, Smooth Muscle ; physiology ; Phosphorylation ; Rats ; Rats, Wistar ; Signal Transduction ; Smad Proteins ; metabolism ; physiology ; Transforming Growth Factor beta1 ; physiology

OBJECTIVETo study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.

METHODSThis study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.

RESULTSAll the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P < 0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.

CONCLUSIONSAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.

Adult ; Asthenozoospermia ; Humans ; Laparoscopy ; adverse effects ; methods ; Length of Stay ; Ligation ; methods ; Male ; Operative Time ; Postoperative Period ; Recurrence ; Spermatic Cord ; blood supply ; Testicular Hydrocele ; etiology ; Treatment Outcome ; Umbilicus ; Varicocele ; surgery ; Veins