Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.

Objective The article was to speed up the dissolution rate of poorly soluble drugs, reduce the configuration time and improve the allocative efficiency by analysis on factors influencing dissolution and adoption of proper allocative approaches accord-ing to different characteristics of insaluble drugs. Methods 5 insaluable drugs were chosen for the study, which were ornithine as-partate, mezlocillin sodium and sulbactam sodium, teicoplanin, omeprazole sodium injection and imipenem and cilastatin sodium.The control group were allocated by routine configuration approach, while the experiment group were improved by increasing the amount of solvent, loosing the powder inside the bottle before configuration, reducing the bubble, adopting special solvent and increasing the dis-solution temperature.Observation and comparative experiment were made on two groups along with the timing from configuration to com-plete dissolution into clear transparent liquid. Results As to the average complete dissolution time of 5 drugs, significant difference was found between two groups([42±5]s vs [246±35]s, [3±1]min vs [30±3]min, [5±1]min vs [10±3]min, [5±3]min vs [10± 5]min, [2±1]min vs [10±1]min, P<0.05).Compared with the control group, the dissolution time of 5 drugs was cut down by 83%, 90%, 50%, 50%, 80%in experiment group. Conclusion Appropriate increase of solvent, loose powder, bubble reduction, special solvent and increased solution temperature contribute to shortening the dissolution time of insoluble drugs and improving the configura-tion efficiency of pharmacy intravenous admixture.

Objective To compare open versus closed reduction in treatment of children with displaced femoral neck fracture whose reduction is delayed by more than 24 hours.Methods We retrospectively reviewed 51 children who had been treated at our department for femoral neck fracture between May 2005 and May 2012 after their reduction had been delayed for more than 24 hours.They were 37 boys and 14 girls,1.7 to 15.5 years of age (average,9.1 years).According to Delbet's classification,27 cases belonged to type Ⅱ,18 to type Ⅲ,and 6 to type Ⅳ.Of them,18 underwent closed reduction and 33 open reduction.Their complications were recorded in detail.Their therapeutic results were evaluated according to Ratliff's criteria and compared between the 2 methods of reduction.Results The 51 children were followed up for an average of 36.7 months (range,from 17 to 61 months).Anatomic reduction was achieved in 6 cases in the closed reduction group (33.3％) and 29 cases in the open reduction group (87.9％),respectively.All fractures healed after an average of 10.9 weeks (range,from 9 to 13 weeks),with one exception of nonunion in the closed reduction group.The incidence of femoral head necrosis in the closed reduction group (27.8％,5/18) was significantly higher than that in the open reduction group (15.2％,5/33) (P ＜ 0.05).According to the Ratliff's evaluation at the final follow-ups,the good to excellent rate in the closed reduction group(66.7％,12/18) was significantly lower than that in the open reduction group (84.8％,28/33) (P ＜0.05).Coxa vara occurred in 3 children in the closed reduction group but in none in the open reduction group.Conclusion Open reduction with internal fixation may lead to better outcomes than closed reduction in the treatment of children with displaced femoral neck fracture whose reduction is delayed by more than 24 hours,probably because open reduction can result in better reduction quality.

OBJECTIVE: To optimize the microwave assisted extraction technology of icariin from Epimedii Folium. METHODS: The microwave assisted extraction technology of icariin from Epimedii Folium was optimized by L9(34)orthogonal design using extraction temperature, extraction time, alcohol concentration,ratio of solid and liquid with the content of icariin as index. RESULTS: The optimal extraction process of icariin was as follows: extraction temperature of 60 ℃,extraction time of 6 min, 30% alcohol and ratio of solid and liquid was 1 ∶ 20. CONCLUSION: The extraction technology is high efficiency and requires short period for extraction of icariin from Epimedii Folium with low cost.

Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; psychology ; Otorhinolaryngologic Surgical Procedures ; Postoperative Period ; Retrospective Studies ; Sinusitis ; psychology ; Treatment Outcome ; Young Adult

Adult ; Aged ; Aged, 80 and over ; Endoscopy ; Epistaxis ; diagnosis ; surgery ; Female ; Hemostasis, Endoscopic ; Humans ; Male ; Middle Aged ; Retrospective Studies

10.3969/j.issn.2095-4344.2013.23.003

Background Oxidative damage plays an important role in pathogenesis of age-related macular degeneration( AMD ),and its mechanism is the destroy of blood-retinal barrier.Müller cells is a primary component to stabilize the inner barrier of the blood-retina.Researches showed that epidermal growth factor(EGF) can promote the proliferation and migration of animal Müller cells,but less study was found in the effect of EGF on human Müller cells. Objective The present study was to investigate the effects of EGF on the proliferation and migration of human Müller cells and its molecular mechanism. Methods Human Müller cell line MIO-M1 cells were cultured and incubated,and cultured cells were identified using glial fibrillory acidic protein (GFAP),factor Ⅷ,α-smooth muscle actin( α-SMA ),keratin and S-100.Different concentrations of EGF( 0,1,10,30,100 mg/L)was added in freeserum DMEM,and the positive rate of the cells was calculated using 5-bromo-2-deoxyuridine(BrdU) method.The cells were divided into EGF group,H2 O2 group,EGF + H2 O2 group,glucose oxidase ( GO ) group,GO + EGF group,EGF + LY294002+H2O2 group according to the different intervention,and the effects of LY294002 on the proliferation of Müller cells (A590 )were detected by colorimetric assay for cellular growth and survival( MTT assay).The scratch test of Müller cells was used to assess the influence of EGF(0,1,10,30,100 mg/L)on H2 O2-induced damage of human Müller cell.Western blot was used to detect the cell proliferation under the protection of EGF on co-cultured cells using LY294002 and H2O2 and the activation of Akt signal pathways. Results The proliferative rates of the cells were 28.0％,32.9％,39.0％ in 10,30,100 mg/L EGF groups respectively and obviously higher than those in 0,1 mg/L EGF groups (24.5 ％,26.2 ％ ).Under the H2O2 culture,GO culture,respectively,the A570 value of the Müller cell in high concentrations of EGF groups was significantly increased in comparison with lower concentrations EGF groups with the statistical significance among the groups( F=23.582,P=0.000).Compared with EGF+H2O2 group,the A570value of the Müller cells was lowed in EGF+LY294002+H2O2 group.The maximum migration rate of Müller cells was found in 10 mg/L EGF group.Western blot revealed that the presence of H2O2 reinforced the expression of Akt in Müller cells,however,pretreatment with 100 mg/L EGF antagonized the harmful effect of H2O2 on Müller cells.Meanwhile,pretreatment with EGF and LY294002 reduced the expression of Akt in Müller cells. Conclusions EGF can induce the proliferation and migration of human Müller cells with the strongest effect in 10 mg/L.100 mg/L exogenous EGF has a stronger protection to the Müiller cells against H2O2-induced cell damage by activating the PI3KAkt cell survival pathway.

Objective: To investigate the association between the genetic polymorphism of ABCB1 C3435T and plasma concentration and adverse reactions of high-dose methotrexate(HD-MTX) chemotherapy in children with acute lymphoblastic leukemia(ALL).Methods: A total of 70 peripheral blood samples were obtained from the children with acute lymphoblastic leukemia for extracting genome DNA.The genetic polymorphism of ABCB1 C3435T locus was examined by using PCR technology and direct sequencing;enzyme-amplified immunoassay (EMIT) was employed to determine the plasma concentration of MTX in 48 h;the clinical data of patients were collected during the HD-MTX chemotherapy, the adverse reactions were statistically analyzed.The association between ABCB1 C3435T genotypes and MTX plasma concentration and adverse reactions were investigated.Results: Genetic polymorphism existed at the SNP of ABCB1 C3435T.At the SNP of ABCB1 C3435T, the percentage of CC, CT and TT genotype in the children with ALL was 31.43%, 47.14% and 21.43%, respectively.The order of C/D ratio of MTX from low to high was CC, CT and TT genotypes, there was a significant association between the gene polymorphism and the C/D ratio of MTX (P<0.05);the order of incidence of oral mucosa damage from low to high was CC, CT and TT genotypes, there was a significant association between the gene polymorphism and oral mucosa damage (P<0.05);the order of incidence of hepatotoxicity from low to high were CC, CT and TT genotypes, the gene polymorphism and hepatotoxicity had a significant association (P<0.05).Conclusion: ABCB1 C3435T genetic polymorphism and C/D ratio of MTX, gastrointestinal side effects and hepatotoxicity after HD-MTX chemotherapy in the children with ALL exhibit significant association.

BACKGROUND: The blood levels of specific markers of platelet activation, such as platelet granule membrane protein (GMP-140) and tumor necrosis factor alpha (TNF-α) are very low in healthy individuals, while the plasma levels of them in patients with cerebral infarction increase. Is the protection of brain hydrolysate injection correlated with the phenomenon?OBJECTIVE: In this study, the plasma levels of GMP-140 and TNF-α in patients with acute stroke were measured, the brain protection of brain protein hydrolysate injection on patients with ischemic stroke were investigated, and were compared with the therapeutic effect of compound danshen injection.DESIGN: It was designed for case study.SETTING: This study was conducted at the Medical Department of the General Hospital of Pingdingshan Coal Co. Ltd and the Neurology Department of the Second Hospital Affiliated to Zhengzhou University.PARTICIPANTS: From January 2001 to October 2003, 144 inpatients with hypertension and acute stroke in the Medicine Department of the General Hospital of Pingdingshan Coal Co. Ltd were selected and divided into 2 groups, as experiment group containing 72 cases, 47 males and 25females, with an age from 42 to 90 and in average of (69±11) years old and control group containing 72 cases, 49 males and 23 females, with an age from 37 to 85 and in average of (68±10) years old.METHODS: All the patients in these two groups underwent oxygen inhalation therapy, antihypeetensive therapy, dehydration therapy and anticoagulation therapy. Patients in control group were coadministered 500 mL compound salvia miltiorrhiza injection QD once a day, with a 14-day course of therapy. Patients in experiment group were treated with 500 mL compound salvia miltiorrhiza injection QD and 20 mL protein hydrolysate European stroke scale (ESS), from 0 (worst possible health status) to 100(best possible health status), were used to evaluate the recovery status of (from 24 hours to 72 hours) and 3 weeks post-treatment, 5 mL blood samples were obtained from antecubital veins, then plasma levels of GMP-140and TNF-α were quantified using an RIA (radioimmunoassay) and the changes in neural function before and after brain protein hydrolysate injection were evaluated.MAIN OUTCOME MEASURES: Before treatment and at 3 weeks postwere quantified using an RIA.RESULTS: All the 144 patients entered the statistical analysis procedure.ESS were significantly higher than the pre-treatment scores [Experiment groups: 79.95±18.64 and 59.65±19.87; Control group: (74.66±15.88) and (61.25±18.68), (t=2.678-4.351, P ＜ 0.01). The post-treatment scores of ESS in experiment group were higher than those in control group (t=2.016-2.158,groups, the post-treatment outcomes were significantly lower than the pre-treatment outcomes [Experiment group: (22.12±9.52) μg/L and (50.41±22.35) μg/L, (1.05±0.24) μg/L and (1.62±0.50) μg/L; Control group: (26.66±8.22) μg/L and (48.63±21.54) μg/L, (1.35±0.44) μg/L and (1.66±0.48) μg/L; (t=2.678-4.351, P ＜ 0.001)]. And the post-treatment levels of the two markers were lower in experiment group than those in control group (t=2.016-2.158, P ＜ 0.05).CONCLUSION: Brain protein hydrolysate injection can significantly decrease the plasma levels of GMP-140 and TNF-α in patients with acute stroke, and it is capable of increasing the ESS scores and improving the impaired neural functions greatly.