OBJECTIVETo investigate the characteristics of the spontaneous isolated superior mesenteric artery dissection (SISMAD) on computed tomography angiography (CTA).

METHODSTwenty-five patients with unexplained acute abdominal pain received CTA.

RESULTSFour cases with the SISMAD were found and all were male with a mean age of (45.3±6.7) years. Two patients had hypertension history. CT showed enlarged diameter of the superior mesenteric artery with dissection in 4 cases, intimal flap and visible false lumen in 2 cases, ulcer-like laceration in 1 case, and intramural hematoma in 1 case. The proximal lacerations or entries were all at the proximal segment of the superior mesenteric artery. CTA classifications were type Ia (n=2), IIb (n=1), and III (n=1). Two patients underwent repeated CTA when discharged, and progressive changes were discovered.

CONCLUSIONCTA can clearly show the characteristics of the superior mesenteric artery dissection, confirm the diagnosis, and provide an important basis for the classification and follow-up observation.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; diagnostic imaging ; Angiography ; methods ; Female ; Humans ; Male ; Mesenteric Artery, Superior ; diagnostic imaging ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo investigate the rehabilitation effect of electroacupuncture (EA) at early stage on hemiplegia in the postoperative patient of hypertensive hemorrhage.

METHODSSeventy-two cases of postoperative patient of hypertensive hemorrhage were divided into an EA group (n = 42) treated with EA at Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Zusanli (ST 36), etc., from 1-3 days after operation, twice each day; and a control group (n = 30) with functional exercises. Their rehabilitation effects were compared after treatment of one month.

RESULTSThe rehabilitation effect in the EA group was significant better than that in the control group (P < 0.01).

CONCLUSIONEA at early stage has good recovery effect for the patient of hemiplegia after operation of hypertensive hemorrhage.

Acupuncture Points ; Electroacupuncture ; Hemorrhage ; Humans ; Hypertension ; Postoperative Period

This article made a definition for the concept of medical quality and medical quality evaluation, clarified logical relations between medical quality and medical service quality. Meanwhile, compared domestic and foreign standards of medical quality evaluation, combed the implementation of medical quality evaluation in China since 1970s. It summarized research development in current medical quality evaluation in China. At last, the necessity of medical quality evaluation construction in TCM hospitals was analyzed for further research in the future.

Objective To measure the concentration of intracellular free Ca2+ ([Ca2+]i) in neuron-like cells resulted from rat bone mesenchymal stem cell (BMSCs) differentiation induced by salvia miltiorrhiza injection and provide some theoretical basis for the BMSCs transplantation. Methods The rat BMSCs were separated from rat bone marrow and cultured in vitro. After induced by basic fibroblast growth factor and 10mL/L salvia miltiorrhiza injection, the cells were identified with immunofluorescence staining against NeuN. The same procedure was performed on primarily cultured hippocampal neurons. Then, the [Ca2+]i of the differentiated neuron-like cells was determined and compared with primarily cultured hippocampal neurons. Results The BMSCs after induced by basic fibroblast growth factor and salvia miltiorrhiza injection expressed neuronal phenotypes similar to the cell appearance of neurons with NeuN. The average fluorescence intensity of the neuron-like cells derived from BMSCs was 984.75±79.51, while the average fluorescence intensity of the primarily cultured hippocampal neurons was 769.42±60.93. No significant difference was found between them (P>0.05). Conclusion The neuron-like cells from rat BMSCs differentiation induced by salvia miltiorrhiza injection possess certain neuronal properties.

OBJECTIVETo investigate the efficiency of damage control surgery (DCS) and predictors of mortality in critically multiple trauma patients.

METHODSFrom May 1998 to February 2007, DCS were carried out in 27 patients with critically multiple trauma. Of the patients 15 cases survived (survival group) and 12 cases died (dead group). The surgical complications, causes of death, demographic, physiologic and medical parameters were collected and compared between the two groups. Multiple logistic regression analysis were performed to identify possible predictors of mortality.

RESULTSThe incidence of surgical complications was 37.0 percent, and the intra-abdominal infections was the most frequent (18.5%). The overall mortality rate was 44.4 percent. The most common causes of death was multiple organ dysfunction syndrome (50.0%). With respect to predicting mortality, statistically significant differences was found in parameters as age, injury severity score (ISS), initial temperature and base excess (BE), estimated blood loss, initial ICU temperature and length of hospital stay. Older age, increased absolute value of initial BE and lower initial ICU temperature were determined as independent predictors of mortality on multiple logistic regression analysis.

CONCLUSIONSThere is a comparable high morbidity and mortality rate in severely injured patients managed with DCS. Increased age, a larger absolute value of initial BE and lower initial ICU temperature could independently predict death of the patients.

Adolescent ; Adult ; Age Factors ; Aged ; Female ; Humans ; Injury Severity Score ; Logistic Models ; Male ; Middle Aged ; Multiple Trauma ; mortality ; surgery ; Multivariate Analysis ; Postoperative Complications ; Prognosis ; Temperature ; Young Adult

BACKGROUNDResearches in arterial elasticity have increased over the past few years. We investigated the effects of simvastatin on vascular stiffness in fat fed rabbits by ultrasonography.

METHODSThirty rabbits were assigned randomly to 3 groups: normal control group (A), the cholesterol group (B), simvastatin group (C: high fat diet for 4 weeks and high fat diet + simvastatin for further 4 weeks). Stiffness coefficient, pressure strain elastic modulus and velocity of pulse waves in abdominal aorta and femoral artery were measured by ultrasonographic echo tracking at the end of the 4th and the 8th weeks.

RESULTSAt the end of the 4th week, stiffness coefficient, pressure strain elastic modulus and pulse wave velocity of femoral artery were significantly increased in group B compared with those in group A. Similarly, at the end of the 8th week, the same parameters of abdominal aorta were significantly increased in group B compared with those in group A. In contrast, stiffness coefficient, pressure strain elastic modulus and pulse wave velocity of femoral artery were significantly decreased in group C compared with those in group B, however, there was no significant difference in parameters of abdominal aorta between groups B and C.

CONCLUSIONShort term administration of simvastatin can improve the elasticity of femoral artery but not abdominal aorta.

Animals ; Anticholesteremic Agents ; therapeutic use ; Aorta, Abdominal ; drug effects ; Blood Flow Velocity ; drug effects ; Dietary Fats ; adverse effects ; Femoral Artery ; drug effects ; Rabbits ; Random Allocation ; Simvastatin ; therapeutic use

OBJECTIVETo study the effect of hydroquinone on apoptosis of bone marrow mononuclear cells, and to evaluate the toxic effect of benzene on stem cells.

METHODSCell morphology was observed by HT fluorescent stain method, and DNA fragments were analyzed by agarose gel electrophoresis. Anti-Annexin V FITC plus PI staining for apoptotic and necrotic rate was examined by flow cytometer.

RESULTSAfter adding different concentrations of hydroquinone to the cells for 6 h culture, the fluorescent intensity of nucleus increased, the color of nucleus became deep and inhomogeneous, and the chromatin was condensed and distributed around the neucleus. DNA ladder was detected in all samples. Cell apoptotic rate in different concentration of hydroquinone groups was significantly higher than that in blank control group (P < 0.05). With the increase of the concentration of hydroquinone, the apoptotic and necrotic rate also increased. The optimal concentration of hydroquinone was 50 micro mol/L. When it was >or= 75 micro mol/L, the necrotic rate increased significantly. Hydroquinone-induced apoptosis was associated with culture time at the concentration of 50 micro mol/L, and the peak apoptotic time was 10 h, then the apoptotic rate decreased and necrotic rate increased.

CONCLUSIONHydroquinone can induce apoptosis of bone marrow mononuclear cells in vitro with dose-effect and time-effect relationship.

Apoptosis ; drug effects ; Bone Marrow Cells ; cytology ; Cells, Cultured ; Dose-Response Relationship, Drug ; Humans ; Hydroquinones ; pharmacology ; Leukocytes, Mononuclear ; cytology ; drug effects ; Mutagens ; pharmacology

Objective: To investigate the effects of spinal manipulation ( SM) on brain functional activity in patients with lumbar disc herniation ( LDH ) .Methods:Eleven patients with LDH were recruited in the study .All patients received 6 times of lumbar SM treatment and then clinical efficacy was evaluated .All patients received brain functional magnetic resonance imaging ( fMRI ) scans before and after SM treatment.Results: Three subjects dropped out and 8 subjects completed the study , among whom 4 cases were effective and 4 ineffective after SM treatment .The required pressure value producing the same level ( VAS 50 ) pain was ( 7 .43 ±1 .47 ) kg and (10.53 ±0.55) kg before and after SM treatment in effective patients ( P<0.05);however , there was no significant difference in ineffective patients ( P>0 .05 ) . Compared to pre-treatment level, the brain functional activity in effective patients was mainly inhibited , the inhibited areas were located in the right side of prefrontal cortex and cerebellum;while the brain functional activity was generally enhanced in ineffective patients.Conclusion:SM can affect the brain functional activity of patients with LDH , the inhibited areas is mainly located in prefrontal cortex and cerebellum when SM treatment is effective .

Objective: To construct a human cervical spine with bilateral vertebral artery fluid-solid coupling model .Methods: Helical CT images under the principle of reverse engineering and meshed in finite element model ( FEM ) related software were used to establish a human cervical spine with bilateral vertebral artery fluid-solid coupling model . In the process of modeling of vertebral body , vertebral artery , ligament , intervertebral disc , cartilage and endplate large anatomic data and cadaver experiments results were referenced .From the morphology and function the simulation of model with real physiological status was tested .Results: The study showed that the stress concentration on the surface of vertebral body and the blood wall of the bilateral vertebral artery , and the result of the volume flow rate-time curve of bilateral vertebral artery of the model were consistent with the published literatures .This model was well consistent with the clinical phenomenon .Conclusion: The three-dimensional FEM of the human cervical spine established by the introduced method has been effectively verified.The modeling method would provide a new tool for research on the cervical spine biomechanics .

Objective:To compare the application effects of domestic polymer based rapamycin eluting stent (Firebird 2) and imported polymer based rapamycin eluting stent (Cypher Select) in percutaneous coronary intervention for patients with coronary atherosclerotic heart disease (CHD) .Methods :CHD patients who were treated with polymer based rapamycin eluting stent from May 2010 to December 2011 at Shanghai Sixth People’s Hospital were enrolled .Patients were divided into the Firebird 2 group (n=139) and the Cypher group(n=125) .The follow‐up period was 25‐40 months ,average (32 .54 ± 3 .90) months . Major adverse cardiovascular events ( MACE , include cardiac death , nonfatal myocardial infarction , revascularization) ,in‐stent restenosis ,and definite stent thrombosis during follow‐up period were collected and analyzed . Results :Compared with Cypher group ,patients in Firebird 2 group had lower rate of male patients (P<0 .05) ,higher levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) ,longer target lesion ,and the number of stents implanted per lesion was greater (P< 0 .05) .Incidences of cardiac death (4 .3% vs 3 .2% ) ,nonfatal myocardial infarction (1 .4% vs 1 .6% ) , revascularization(4 .3% vs 5 .6% ) ,MACE(9 .4% vs 8 .8% ) ,in‐stent restenosis and definite stent thrombosis all had no significant differences between the two groups .Logistic regression analysis showed that age (OR= 1 .11 ,95% CI 1 .05‐1 .18 , P=0 .000) ,diabetes (OR = 2 .70 ,95% CI 1 .02‐7 .15 , P= 0 .045) were independent risk factors of MACE ,stent type (OR=0 .88 ,95% CI 0 .34‐2 .24 ,P=0 .782) was not an independent risk factor of MACE .Conclusions :Firebird 2 rapamycin eluting stent and Cypher rapamycin eluting stent have similar long‐term clinical efficacy and safety in the treatment of CHD .