Age - related macular degeneration ( AMD ) is the leading cause of irreversible visual loss in elderly people among white - dominated population. At percent, treatment for AMD includes anti - vascular endothelial growth factor antibody ( Anti- VEGF ) drug treatment, photodynamic therapy ( PDT ) , topical application of triamcinolone acetonide ( TA ) and laser therapy ( nanosecond laser) etc. Through comparative analysis of different treatment methods of AMD, we review the mechanism, clinical efficacy, adverse events and cost effectiveness to provide the basis for clinical treatment.

AIMTo compare the influences of wood-cultured Ganoderma lucidum polysaccharides (Gl-PS-WC) and bag-cultured Ganoderma lucidum polysaccharides (Gl-PS-BC) on the proliferation activities of murine spleen lymphocytes in vitro, and investigate whether Gl-PS-BC can be substituted for Gl-PS-WC.

METHODSMixed lymphocyte culture (MLC) reaction, lymphocyte proliferation induced by concanavalin A (Con A, 1 mg.L-1) or lipopolysaccharide (LPS, 5 mg.L-1), MLC reactions inhibited by immunosuppressive drugs, cyclosporine A (CsA, 0.1 mg.L-1), mitomycin (Mit C, 0.1 mg.L-1), or antitumor drug, etoposide (VP-16, 0.1 mg.L-1), were detected in the presence or absence of Gl-PS-WC and Gl-PS-BC in the concentration range of 0.2-12.8 mg.L-1.

RESULTSTwo kinds of polysaccharides were shown to promote MLC in the range of 0.2-12.8 mg.L-1, increase lymphocyte proliferation induced by Con A or LPS and antagonize the inhibitory effects of CsA, Mit C or VP-16 on MLC. No significant difference was observed between these two kinds of polysaccharides in selected concentrations.

CONCLUSIONGl-PS-WC and Gl-PS-BC showed similar effects on the proliferation activities of murine spleen lymphocytes in vitro.

Animals ; Cell Division ; drug effects ; Cell Separation ; Cyclosporine ; antagonists & inhibitors ; Lymphocyte Culture Test, Mixed ; Lymphocytes ; cytology ; drug effects ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Plants, Medicinal ; chemistry ; growth & development ; Polysaccharides ; isolation & purification ; pharmacology ; Reishi ; chemistry ; growth & development ; Spleen ; cytology ; Wood

Objective To discuss the feasibility and effects of cemented artificial bipolar arthroplasty for senile patients with femoral intertrochanteric instable fractures. Methods From January 2004 to June 2008,46 aged cases with femoral intertrochanteric instable fractures were cured with cemented artificial bipolar arthroplasty. According to improving-classfication of Evans,there were 19 cases with type Ⅲfractures and 27 cases with type Ⅳ fractures. Results All cases were successfully operated. The surgery time was 50-90 (68.00 ±20.43) minutes. Bleeding volume was 160-600 (210.00 ±40.26) ml. The time in hospital was 16-26 (19.30 ± 4.56) days. All cases were retrospectively reviewed for 6-39 (17.10 ± 4.33)months. Three cases died of other diseases, 43 cases were graded by the system of Harris. The Harris scale was 70-94 (86.70 ±5.16) scores,and the choiceness rate was 90.7%(39/43). No dislocation,loosening,subsidence and late infection occurred in all the implants. Conclusions Cemented artificial bipolar arthroplasty has good advantages of reduced laying up period and few complications. The short-term outcome is satisfactory.

OBJECTIVETo observe the influence of rhubarb on gastrointestinal motility and intestinal mucosal barrier in patients with severe burn.

METHODSThirty patients with severe burn admitted to our burn wards within 48 hours after burn injury from December 2009 to December 2010 were divided into therapeutic group (T, treated with 10 g rhubarb by nasal feeding and 5 g L-glutamine by oral administration beginning from 6 hours after admission, three times per day, and also given enteral nutrition beginning from 24 hours after admission, n = 16) and control group (C, received the same treatment as used in T group but without rhubarb, n = 14) according to the random number table. Gastrointestinal function indexes including restoration of bowel sound within 24 hours, abdominal distension, tolerance to enteral nutrition, and defecation were observed after treatment. The serum samples were harvested on post burn day (PBD) 3, 7, 14 for determination of the levels of gastrin (GAS) by radioimmunoassay, motilin (MTL) by enzyme-linked immunosorbent assay, diamine oxidase (DAO) by enzyme spectrophotometry, and endotoxin (ET) by kinetic turbidimetric assay with TAL. Data were processed with t test and chi-square test.

RESULTSCompared with those in C group, the numbers of patients with restoration of bowel sound within 24 hours and tolerance to enteral nutrition in T group were increased (with chi2 value respectively 5.01, 4.84, P values all below 0.05), the number of patients with abdominal distension was decreased (chi2 = 4.84, P = 0.025). Compared with those of C group, defecation time was earlier, number of bowel movement was increased with soft feces in patients of T group. The serum levels of GAS in T group on PBD 3, 7, 14 [ (92 +/- 26), (95 +/- 16), (98 +/- 18) ng/L] were significantly higher than those in C group [(80 +/- 15), (75 +/- 17), (79 +/- 13) ng/L, with t value respectively 15.352, 22.951, 19.263, P values all below 0.01]. The serum levels of MTL in T group on PBD 3, 7, 14 [(246 +/- 80), (299 +/- 76), (300 +/- 100) ng/L] were significantly higher than those in C group [(189 +/- 44), (203 +/- 64), (200 +/- 67) ng/L, with t value respectively 14.173, 19.294, 26.298, P values all below 0.01]. The serum levels of ET in T group on PBD 3, 7, 14 [(0.398 +/- 0.035), (0.373 +/- 0.005), (0.238 +/- 0.019) EU/mL] were significantly lower than those in C group [(0.493 +/- 0.043), (0.501 +/- 0.045), (0.423 +/- 0.099) EU/mL, with t value respectively 6.213, 9.153, 15.134, P < 0.05 or P < 0.01]. The serum levels of DAO in T group on PBD 3, 7 [ (3.0 +/- 0.4), (2.9 +/- 0.5) U/mL] were significantly lower than those in C group [(3.9 +/- 0.5), (3.6 +/- 0.6) U/mL, with t value respectively 3.982, 4.236, P values all below 0.05], and there was no obvious difference between T and C groups on PBD 14 (t = 1.762, P > 0.05).

CONCLUSIONSRhubarb can protect intestinal mucosal barrier in patients with severe burn through increasing secretion of gastrointestinal hormones and promoting restoration of gastrointestinal motility.

Adolescent ; Adult ; Aged ; Burns ; drug therapy ; physiopathology ; Female ; Gastrointestinal Motility ; Humans ; Intestinal Mucosa ; physiopathology ; Male ; Middle Aged ; Phytotherapy ; Rheum ; Young Adult

OBJECTIVETo investigate the clinical application, feasibility and value of 3 T whole-heart contrast enhanced free-breathing navigator-gated three-dimensional coronary magnetic resonance angiography (CE-CMRA).

METHODS3 T CE-CMRA was used to examine patients with suspected coronary heart disease (CAD). Gd-BOPTA (0.2 mmol/kg) was injected intravenously with slow infusion rate (0.3 ml/s) to perform enhancement. Data were post-processed to obtain principal branches of coronary artery and picture quality was evaluated. According to results of selective coronary arteriography (SCAG), the diagnostic accuracy of CE-CMRA for diagnosing CAD was judged by means of detecting significant stenosis (> 50%) of the principal branches based on the 9 segments of coronary artery.

RESULTSTwenty-three out of 26 patients successfully completed the examination. The mean scanning time was (10.4 ± 2.1) minutes, 178 out of 202 (88.1%) SCAG demonstrated segments could be evaluated by CE-CMRA. The imaging quality was superior in proximal and middle segments of coronary artery principal branches than in distal segments. Based on patient-level, there were 9 positive cases and 14 negative cases examined by CE-CMRA compared with 11 positive cases and 12 negative cases examined by SCAG, respectively. The whole diagnose accordance rate of CE-CMRA was 91.3% (21/23) compared with SCAG. The sensitivity, specificity and negative predictive values were 81.8% (9/11), 88.5% (169/191) and 98.8% (9/31) respectively.

CONCLUSIONS3 T CE-CMRA is a feasible non-invasive imaging modality for diagnosing CAD, especially to detect significant stenosis in proximal and middle segments of coronary artery principal branches. However, the detecting efficacy is limited in assessing stenosis of distal segment and small branches of coronary artery.

Aged ; Coronary Angiography ; methods ; Coronary Vessels ; pathology ; Female ; Heart ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Angiography ; methods ; Male ; Middle Aged

BACKGROUNDNosocomial infection caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) could lead to increased morbidity and mortality. In 2006, VRE nosocomial spread became a reality in our hospital since the first VRE nosocomial infection in 2003. Little is known about the prevalence of coexistence with VRE and MRSA in the patients. The primary objective of the study was to identify the molecular characteristics of epidemic MRSA clones in our hospital and the prevalence of the coexistence with MRSA and VRE in same patients during the 2-year period, 2006 - 2007.

METHODSThe clinical features, laboratory test results, and therapeutic outcomes of 129 cases who isolated MRSA collected from January 2006 to December 2007 were retrospectively analyzed. Polymerase chain reaction (PCR) was used to determine mecA-femB type and staphylococcal cassette chromosome mec (SCCmec) type. All the participants were screened for clinical and microbiological data to identify the coexistence of VRE strains with MRSA.

RESULTSOne hundred and twenty-nine MRSA isolates were included in the study: 71 (55%) from the intensive care unit, 35 (27.2%) from the surgical wards and 23 (17.8%) from the medical wards. The most frequent source of isolation of MRSA was sputum (76.7%). From seven patients we isolated MRSA and VRE (E. faecium) simultaneously during their inpatient stay. One hundred and twenty-seven (127/129, 98.4%) MRSA isolates harboured SCCmec type III, only 2 MRSA strains contained SCCmec type II. All of the 129 MRSA isolates remained sensitive to vancomycin, teicoplanin and linezolid. Higher sensitivity rates were noted for chloramphenicol 99.2% (128/129). Only 20.2% (26/129) of the MRSA isolates were sensitive to rifampin. All isolates presented resistance to multiple antimicrobial agents with high minimum inhibitory concentrations (MICs), including: beta-lactams (penicillin, oxacillin, cefoxitin, and cefazolin), tetracycline, erythromycin, gentamicin, and quinolones (ciprofloxacin, levofloxacin, and moxifloxacin).

CONCLUSIONSThe predominant MRSA clone at Beijing Chaoyang Hospital from 2006 to 2007 had the type III SCCmec element. All of the MRSA isolates were multiresistant to antimicrobial agents. Emergence of coexistence of MRSA and VRE in the same patient was not rare. Physicians should pay more attention to infections resulting from MRSA and VRE. Aggressive infection control measures should be taken to prevent the transmission of the multidrug resistance organism.

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; China ; Chromosomes, Bacterial ; genetics ; Enterococcus ; drug effects ; genetics ; physiology ; Gram-Positive Bacterial Infections ; epidemiology ; Hospitals ; statistics & numerical data ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; genetics ; physiology ; Microbial Sensitivity Tests ; Middle Aged ; Polymerase Chain Reaction ; Prevalence ; Staphylococcal Infections ; epidemiology ; Vancomycin Resistance

OBJECTIVETo analyze the Y chromosome microdeletions in the family of the infertile male and to study on the vertical transmission of Y chromosome microdeletions from father to son.

METHODSThe peripheral blood of infertile patients' family male members was extracted and analyzed with modified multiplex PCR. The infertile family tree was drawn according to the results.

RESULTSTwo cases in twelve investigated families had azoospermia factor (AZFc) microdeletion heredity. The others had no heredity.

CONCLUSIONAZFc microdeletion of the Y chromosome can be transmitted to the male offspring naturally,and the same deletion can result in different phenotypes in different individuals.

Adult ; Aged ; Azoospermia ; genetics ; Chromosome Deletion ; Chromosomes, Human, Y ; genetics ; Family Health ; Female ; Humans ; Infertility, Male ; genetics ; Male ; Middle Aged ; Pedigree ; Young Adult

OBJECTIVETo study the compatibility of dosage change of Zhishi, Houpo and Mangxiao affecting the yields of Anthraquinone components in Dachengqi decoction.

METHODResponse surface methodology (RSM) with Doehlert design was adopted to evaluate the yields of Anthraquinone components in Dachengqi decoction by dosage change of Zhishi, Houpo and Mangxiao and the analysis time was shorten through a desirability function.

RESULTResults show that Anthraquinone components were got a high yields when the dosage ratio of Dachengqi decoction were compatible as follows: Dahuang-Zhishi-Houpo-Mangxiao (1:4:2. 31:2).

CONCLUSIONThe Doehlert design with a desirability function, which allow a sequential response methodology, is a good methods, and, of cause, the mathematical model can be further extended and applied to the compatibility research of Chinese material medicine.

Anthraquinones ; analysis ; Dosage Forms ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Models, Chemical ; Plant Extracts ; administration & dosage ; chemistry

Objective To investigate the performance of triple rule-out with(M-slice spiral CT in the combined examination of pulmonary artery,thoracic aorta and coronary artery for patients with acute chest pain.Methods Seventy patients who presented with acute chest pain were included in the study.All of the patients underwent retrospective ECG-gated 64-slice computed tomography triple rule-out examination to evaluate the pulmonary arteries,thoracic aorta and coronary arteries.Multi-planar reconstruction(MPR), maximum intensity projection(MIP),curved-planar reconstruction(CPR)and volume rendering(VR) were used to display pulmonary arteries,thoracic aorta and coronary arteries.We evaluated the image quality of coronary artery and the enhancement of the pulmonary artery and thoracic aorta to estimate if the examination can fulfill the clinical demand for the differential diagnosis of acute chest pain.Results The mean scan time was(8.5?1.0)s,and the dose of contrast medium injected was 100 ml.There were 95.7%(67/70)of patients whose CT values detected in the pulmonary artery and thoracic aorta after enhancement were ≥200 HU.The image quality of 85.8%(720/839)coronary segments was classified as excellent,8.6%(72/839)as good,and 5.6%(47/839)as poor.There were 20 cases with coronary stenoses≥50%,2 cases with pulmonary embolism,and 2 cases with aortic dissection.Conclusion The triple ride-out examination with 64-slice spiral CT could depict pulmonary artery,thoracic aorta,and coronary artery in 8 s with good image quality.It has great potential in the etiological diagnosis for the patients with acute chest pain.