Adenocarcinoma, Clear Cell ; pathology ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; pathology

BACKGROUND:There is controversial on which method is preferred for the treatment of humeral shaft fractures, plate or intramedul ary nail fixation? Some studies have compared the effect of those two methods, but the results are different. While the results of the systematic research and the Meta-analysis on the comparative studies is also different due to the differences in the number and the extraction of the researches.
OBJECTIVE:To systematical y evaluate the efficacy of plating versus intramedul ary nail fixation in the treatment of adult humeral shaft fracture.
METHODS:A computer-based retrieve was conducted in PubMed database, MEDLINE database, Cumulative Index to Nursing&Al ied Health Literature, Evidence-Based Medicine database, CBM database, Wanfang database and CNKI database for the randomized or quasi-randomized control ed trials on the comparison of plating and intramedul ary nail fixation in the treatment of adult humeral shaft fracture. The quality of these trials was critical y assessed according to Jadad. The effective data were extracted for Meta-analysis by Stata 12.0 software.
RESULTS AND CONCLUSION:Total y, 15 randomized or quasi-randomized control ed trials were col ected including four quasi-randomized control ed trials and 11 randomized control ed trials. The results showed that intramedul ary nail fixation may increase the risk of complications (odds ratio=0.37(0.19, 0.59), P=0.00). Bias Egger’s test of P=0.91 showed there was no significant publication bias. The risk of re-operation of intramedul ary nail fixation was increased (odds ratio=0.28(0.14, 0.57), P=0.00) with the Egger’s test of P=0.69. The incidence of shoulder impingement of intramedul ary nail fixation was significantly higher than that of pate fixation (odds ratio=0.13(0.05, 0.35), P=0.00), and there were no significant differences in postoperative infection, nonunion, implant failure, iatrogenic nerve palsy, operation time and bone union time between two methods. The results showed that compared with plate fixation, intramedul ary nail fixation may increase the incidence of shoulder impingement, complications and re-operation, while there were significant differences in postoperative infection, nonunion, implant failure, iatrogenic nerve palsy, operation time and bone union time between two methods.

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

Objective To evaluate the clinical effect in the treatment of the young patients(≤45 years old) with acute myocardial infarction(AMI)underwent emergent percutaneous transluminal coronary angioplasty(PTCA) combined with Lipo-PGE_1.Methods 39 patients with AMI(paroxysm within 12 hours),were underwent emergent PTCA(coronary stem performed in some patients),including 18 cases which were treated combined with Lipo-PGE_1 in the mean time.And the clinical efficacy and the results of short-period follow-up were recorded.Results The in- farctive vasculars were re-open in 37 patients(23 cares were routinely placed translunrinal srents),and the successful rate was 94.9 %.Those who also used Lipo-PGE_1 were re-open in 17 patients.The successful rate was 94.4 %,their ST segments on EKG 30 minutes after operations reduced significantly than that of patients who did not use Lipo- PGE_1,their cardial functions were also improved significantly 24 hours after operations and no side effects on blood pressure and heart rate were observed.Conclusion The emergent PTCA combined with Lipo-PGE_1 for acute my- ocardial infarction can protect the cardial function and show a better early therapy effect.

OBJECTIVETo explore the clinical classification method of keloids and providing a thread for the treatment of keloids.

METHODSTo summarize the 600 cases of keloid patients we accepted and diagnosed from November 2004 to October 2012, and filling in keloid patients information sheet, recording the keloids form by photographs, analyzing the treatment, putting forward the classification method of keloids in clinic.

RESULTSAccording to the position and quantity that keloids grow, the keloid patients are divided into four major categories:one in single site, one in each site, more than one in single site and more than one in each site; According to the area and thickness of keloids, the keloid single lesion is divided into four subclasses: type of small area and thin, type of small area and thick, type of large areas and thin,type of large areas and thick; According to the number of lesions, keloid multiple lesions is divided into two subgenera: isolated multiple and dispersion multiple, different kinds of keloids suit different methods of treatment.

CONCLUSIONThe clinical classification method of keloids can be used to provide thought for the treatment of keloids, and have a good application value.

Humans ; Keloid ; classification ; pathology ; therapy

BACKGROUNDPatients with severe full-thickness burn injury suffer from their inability to maintain body temperature through perspiration because the complete destructed sweat glands can not be regenerated. Bone marrow-derived mesenchymal stem cells (BM-MSCs) represent an ideal stem-cell source for cell therapy because of their easy purification and multipotency. In this study, we attempted to induce human BM-MSCs to differentiate into sweat gland cells for sweat gland regeneration through ectodysplasin (EDA) gene transfection.

METHODSThe dynamic expression of EDA and EDA receptor (EDAR) were firstly observed in the sweat gland formation during embryological development. After transfection with EDA expression vector, human BM-MSCs were transplanted into the injured areas of burn animal models. The regeneration of sweat glands was identified by perspiration test and immunohistochemical analysis.

RESULTSEndogenous expression of EDA and EDAR correlated with sweat gland development in human fetal skin. After EDA transfection, BM-MSC acquired a sweat-gland-cell phenotype, evidenced by their expression of sweat gland markers by flow cytometry analysis. Immunohistochemical staining revealed a markedly contribution of EDA-transfected BM-MSCs to the regeneration of sweat glands in the scalded paws. Positive rate for perspiration test for the paws treated with EDA-transfected BM-MSCs was significantly higher than those treated with BM-MSCs or EDA expression vector (P < 0.05).

CONCLUSIONSOur results confirmed the important role of EDA in the development of sweat gland. BM-MSCs transfected with EDA significantly improved the sweat-gland regeneration. This study suggests the potential application of EDA-modified MSCs for the repair and regeneration of injured skin and its appendages.

Adult ; Animals ; Blotting, Western ; Bone Marrow Cells ; cytology ; Cell Proliferation ; Cells, Cultured ; Ectodysplasins ; genetics ; metabolism ; Female ; Flow Cytometry ; Humans ; Immunohistochemistry ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Pregnancy ; Receptors, Ectodysplasin ; Reverse Transcriptase Polymerase Chain Reaction ; Sweat Glands ; cytology ; metabolism ; Transfection ; Young Adult

OBJECTIVETo evaluate the impact of different proton pump inhibitors on the antiplatelet activity of clopidogrel.

METHODSA total of 60 hospitalized patients undergoing percutaneous coronary intervention were randomly assigned to receive omeprazole group 40 mg/d (20 patients), pantoprazole group 40 mg/d (20 patients) and control group (20 patients). All patients also received standard clopidogrel therapy, continuing 30 days treatments. The percentage clotting inhibition was measured by the use of thrombelastogram and the maximal platelet aggregation rate (MPAR) was measured by turbidity method at the first day before admission and 15 or 30 days after treatment. Major adverse cardiac and cerebral events (MACCE) and hemorrhagic events within 30 days were recorded.

RESULTSThe baseline clinical characteristics, angiography and PCI result were compared among the three groups. At the first day before admission and 15 or 30 days after treatment, no significant difference was shown in the percentage clotting inhibition measured by thrombelastogram and the maximal platelet aggregation rate (MPAR) measured by turbidity method among the three groups. Though the platelet agglutination inhibition rate measured at 15 and 30 days increased and MPAR measured at 15 and 30 days declined compared with the baseline data (P < 0.05), no significant difference was found between levels measured at 15 and 30 days (P > 0.05). The rates of MACCE had no significant difference among the three groups. Compared with control group, the rates of hemorrhagic event were significantly decreased in omeprazole or pantoprazole group (P < 0.05), but no significant difference was shown between the omeprazole and pantoprazole group.

CONCLUSIONNo significant impact of different proton pump inhibitors on the antiplatelet activity of clopidogrel has been found in patients undergoing coronary stent implantation and short-time combined administration is safe.

2-Pyridinylmethylsulfinylbenzimidazoles ; pharmacology ; therapeutic use ; Adult ; Aged ; Angioplasty, Balloon ; Aspirin ; pharmacology ; therapeutic use ; Coronary Disease ; therapy ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Omeprazole ; pharmacology ; therapeutic use ; Platelet Aggregation ; drug effects ; Postoperative Period ; Proton Pump Inhibitors ; pharmacology ; therapeutic use ; Stents ; Ticlopidine ; analogs & derivatives ; pharmacology ; therapeutic use

OBJECTIVETo describe the temporal trends in the mortality rate of gastric cancer during the period of 1988 and 2010, and to predict the gastric cancer mortality between 2016 - 2020.

METHODSThe data of gastric cancer mortality in Linzhou city between 1988 and 2010 was extracted from the cancer registry, including a total of 11 714 cases, covering 22 447 073 person-years. The mortality rate of gastric cancer of each 5-year period was calculated by sub-site and gender. Age-standardized rate (ASR) was calculated using the Chinese standard population in 1982. Intrinsic estimator (IE) model was used to fit the mortality trend by sub-site and gender, and to predict the mortality of gastric cancer in Linzhou city between 2016 and 2020.

RESULTSFrom 1988 to 2010, the gastric cancer mortality in Linzhou city was 52.18/100 000 (11 714/22 447 073) with the ASR at 49.23/100 000; the mortality in male was 67.02/100 000 (7678/11 455 512) with ASR at 68.68/100 000 while the mortality in female was 36.72/100 000 (4036/10 991 561) with ASR at 32.12/100 000. The mortality of cardia carcinoma was 27.87/100 000 (6257/22 447 073) with the ASR at 26.37/100 000; while the mortality of non-cardia carcinoma was 24.31/100 000 (5457/22 447 073) with the ASR at 22.86/100 000. The ASR of gastric cancer during 1988 - 1990 was 63.37/100 000 (1653 cases) and decreased by 28.34%, to 45.41/100 000 (2622 cases) during 2006 - 2010. The IE model showed that the birth cohort effect decreased greatly. The mortality risk of cardia carcinoma in population born after 1950s, decreased significantly; and the mortality risk of non-cardia carcinoma in population born in 20 century continually decreased. The death of gastric cancer among the population over 30 years old was predicted to be 3626 cases, increasing by 40.60% compared with the number between 2006 and 2010 (2579 cases). Among them, the mortality of cardia carcinoma increased by 51.89% (predicted number between 2016 and 2020 was 2456 cases, and 1617 cases between 2006 and 2010), and the mortality of non-cardia carcinoma increased by 21.62% (predicted number between 2016 and 2020 was 1170 cases, and 962 cases between 2006 and 2010).

CONCLUSIONThe mortality rate of gastric cancer in Linzhou city showed a decreasing trend during the period of 1988-2010, being mainly attributed to the cohort effect. However, the mortality will still increase in the future, between 2016 and 2020.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Forecasting ; Humans ; Male ; Middle Aged ; Registries ; Stomach Neoplasms ; epidemiology ; mortality

OBJECTIVEAim of this study was to investigate functions of lower esophageal sphincter (LES) barrier and esophageal clearance in fasting and postprandial stages in gastroesophageal reflux disease (GERD).

METHODSEight patients with confirmed GERD and 8 healthy subjects (HS) were observed in the study. The esophageal pH and manometry were recorded simultaneously for 1 h during fasting and 2 h after a meal (1,675 kJ) using pneumohydrolic capillary perfusion system.

RESULTS(1) The esophageal pH monitoring showed that median of percentage of pH < 4 at postprandial in HS and patients with GERD was 0.45% and 11.2%, respectively (P < 0.05). (2) Pressure of lower esophageal sphincter (LESP) significantly decreased after a test meal in GERD (P < 0.001) and in HS (P < 0.001). (3) The amplitude of post-LES relaxation related to swallow (post-LESRA) in GERD was much lower than in HS either during fasting or postprandial stage (P < 0.05). (4) The tension of crural diaphragm at resting (Dia-A0) in GERD was lower than in HS during fasting and postprandial stage(P < 0.05). (5) The tension of crural diaphragm at deep inspiration (dia-AM) in GERD and HS increased 3 or 4 times at pressure at gastroesophageal junction (GEJ). (6) The peristaltic amplitude of the distal esophagus in GERD were much lower than that in HS in both pre- and postprandial periods.

CONCLUSIONS(1) Impaired clearance of Post-LESRA and esophageal body, function of diaphragmatic crural play an important role in development of GERD. (2) The tension of crural diaphragm at deep inspiration can increase the pressure at GEJ.

Adolescent ; Adult ; Aged ; Diaphragm ; physiopathology ; Esophagogastric Junction ; physiopathology ; Esophagus ; physiopathology ; Gastroesophageal Reflux ; physiopathology ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Middle Aged ; Peristalsis

BACKGROUNDMycobacterium abscessus (M. abscessus) can cause a variety of human infections, involving the lung, skin and soft tissues, and is generally believed to be acquired from environmental sources. The aim of this study was to investigate the molecular diversity and antibiotic susceptibility of M. abscessus isolates as the basis for strategies to improve control and management of infection.

METHODSSeventy M. abscessus isolates from patients attending the Guangzhou Thoracic Hospital were identified from 2003 to 2005 by biochemical tests, gas chromatography, polymerase chain reaction (PCR)-restriction analysis (PRA) of heat shock protein gene hsp65, and sequencing of the quinolone resistance determining regions (QRDRs) of gyrA. Susceptibilities to six antibiotics were determined by micro-broth dilution. Isolates were genotyped using randomly amplified polymorphic DNA (RAPD) analysis.

RESULTSMost isolates (63/70; 90%) were susceptible to amikacin but rates of susceptibility to other antibiotics varied from moderate, clarithromycin (60%) and imipenem (43%), to low for ciprofloxacin and ofloxacin (3%), and 87% of isolates had intermediate susceptibility to cefoxitin. RAPD analysis showed that the 70 clinical isolates displayed 69 unique RAPD patterns.

CONCLUSIONSThe high genetic diversity of isolates suggests that they are not transmitted from person to person but, presumably, are acquired independently from environmental sources. M. abscessus isolates displayed variable levels of susceptibility to all antibiotics tested, other than amikacin, indicating a need for routine susceptibility testing to guide treatment.

Amikacin ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Cefoxitin ; pharmacology ; China ; Chromatography, Gas ; Ciprofloxacin ; pharmacology ; Clarithromycin ; pharmacology ; Imipenem ; pharmacology ; Microbial Sensitivity Tests ; Mycobacterium ; drug effects ; genetics ; Polymerase Chain Reaction ; Random Amplified Polymorphic DNA Technique