OBJECTIVETo evaluate the treatment outcomes of sacral nerve stimulation(SNS) for functional anorectal pain(FAP).

METHODSA total of 32 patients of FAP received SNS treatment through S3 from March 2011 to December 2011. Visual analogue scale(VAS), anal pressure measure, and health survey(SF-36) before and after treatment were used to evaluate the outcomes.

RESULTSAfter treatment, VAS score was significantly decreased, rectal anal reflex threshold volume elevated, and anal maximum contraction pressure (AMCP) and anal rest pressure significantly decreased compared with those before treatment(all P<0.01). Except for general health, the remaining dimension score of the SF-36 increased significantly after treatment, and the differences were statistically significant(P<0.05 or P<0.01). After SNS treatment, 19 cases were cured, 12 improved, 1 was refractory. The total effective rate was 96.9% during 3 months after treatment.

CONCLUSIONSNS is a safe and effective alternative for FAP and can alleviate the pain symptom and improve the quality of life.

Fecal Incontinence ; Humans ; Lumbosacral Plexus ; Pain ; Pain Management ; Quality of Life ; Rectum ; physiopathology ; Spinal Cord ; physiopathology ; Treatment Outcome

OBJECTIVETo observe the protective effects of histone deacetylase inhibitor on stress-induced myocardial injury.

METHODSHealthy male Wistar rats were randomly divided into 3 groups( n = 6), and the stress-induced myocardial injury model was established with chronic restraint stress method. The protective effects of histone deacetylase inhibitor on stress-induced myocardial injury were observed with Trichostatin A (TSA) intervention. Histone acetylation levels in myocardium of rats were detected by Western blot method, spectrophotometry method was used to dynamically determine the activity of rat serum lactate dehydrogenase (LDH), serum creatine kinase isoenzyme-MB (CK-MB) and Caspase 3, and nagar Olsen staining were used to observe the early myocardial damage.

RESULTSRestraint stress could significantly reduce the level of histone acetylation of myocardium in rats, and TSA intervention could inhibit the stress-induced reduction of myocardial levels of histone acetylation. Restraint stress could cause the significant increase of serum LDH activity ( P < 0.05), serum CK-MB activity ( P < 0.05), and the Caspase 3 activity of myocardial tissue (P < 0.05), and early myocardial damage also occurred during restraint stress. ISA intervention could significantly reduce the serum LDH activity (P < 0.05), the serum CK-MB activity (P < 0.05), the activity of myocardial tissue caspase 3 induced by restraint stress (P < 0.05), and the stress-induced myocardial injury was also attenuated by TSA intervention.

CONCLUSIONThe histone deacetylase inhibitor TSA can protect stress-induced myocardial injury.

Acetylation ; Animals ; Cardiotonic Agents ; pharmacology ; Caspase 3 ; blood ; Creatine Kinase, MB Form ; blood ; Histone Deacetylase Inhibitors ; pharmacology ; Hydroxamic Acids ; pharmacology ; L-Lactate Dehydrogenase ; blood ; Male ; Myocardium ; pathology ; Rats ; Rats, Wistar ; Restraint, Physical ; Stress, Physiological

AIM: To evaluate the safety and efficacy of intravitreal bevacizumab ( avastin ) injection in patients with exudative age related macular degeneration ( AMD) .
METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for AMD were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography and fundus fluorescein and/or indocyanine green angiography. Observation was made on the best corrected visual acuity ( BCVA) , intraocular pressure, and the changes of lens, vitreous, central retinal thickness (CFT) and total macular volume (TMV), at 1d, 3d, 7d, 1mo and 6mo after the treatment and then compared with those of pre - operation. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. And all cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given once every 6wk.
RESULTS:All 50 eyes of 48 patients with the average of 58±20. 46 years old were included. The mean baseline of BCVA and CFT were 0. 82±0. 53, and 364. 97±151. 83μm respectively. Although there was no significant decrease in mean CFT and TMV one week after the injection, the mean BCVA had significant improvement. At the last visit of 9. 7mo follow - up, BCVA, CRT and TMV showed significant improvements over baseline values. BCVA was improved by at least two lines in 32 eyes (64%),remained stabilization in 18 eyes (36%) at the last visit. A total of 98 injections were performed and the average number of injections was 1. 98 for each eye in the group. About 50%of re - injections gained at least two lines of vision improvement one week postoperatively. There were no serious adverse events during the treatment.
CONCLUSION: Intravitreal bevacizumab ( avastin ) injection for managing CNV due to age-related macular degeneration is safe and few side effects. Intravitreal avastin associated with improvement in visual acuity ( VA ) , which can reduce macular edema and choroidal neovascularization leakage. But a prolonged treatment effect needs further observation.

Objective To explore the clinical skills and curative efficacy of Glubran (NBCA-MS) embolization of cerebral arteriovenous malformations. Methods Ninety-six cases of cerebral arteriovenous malformations were treated by 187 endovascular embolizations with different concentrations of Italy GEM company's Glubran (NBCA-MS). Follow-up was performed to 96 cases of cerebral arteriovenous malformation with NBCA-MS embolization. Results During the follow-up in 96 cases, clinical symptoms completely disappeared in 92, were improved in 3 and reoccurred in 1. The malformation was totally got rid of in 44 of 48 cases DSA examinated, and the 80%-90% embolization was achieved in the rest who need further γ-knife therapy. In all cases, γ-knife therapy was performed in 32 cases after embolization, and among them 26 cases received DSA examination 1-2 years after γ-knife therapy, and 21 cases were proved to have no malformation. Conclusions The method ofendovascular emdolization with NBCA-MS is safe, reliable and effective to treat the cerebral arteriovenous malformation.

Objective To study the short-term and long-term effectiveness of intracranial aneurysm occlusion with expandable hydrocoil. Methods Forty-one patients with intracranial aneurysms (n=45) were treated by endovascular occlusion with expandable hydrocoil. Follow-up interviews in the forms of DSA, CTA or MRA were conducted to the 41 patients within 6-24 months after the treatment to find out the tumor recurrence and complications. Results In the 41 patients, 1 died, 1 suffered from recurrence, 3 developed cerebral infarction, 1 got oculomotor paralysis, 2 got hydrocephalus. According to modified Rankin scale, grade 0 in 8 cases, grade 1 in 19, grade 2 in 7, grade 3 in 3, grade 4 in 2, grade 5 in 1 and grade 6 in 1. Conclusions Endovascular embolization with expandable hydrocoil is an effective treatment method for intracranial aneurysms, especially for parent artery occlusion, but it may be able to cause more complications in the treatment of small aneurysms (＜5mm), so the caution should be taken.

Objective To explore the treating effect and nursing methods of sacral nerve stimulation (SNS) for patients with spastic pelvic floor syndrome (SPFS).Methods 36 cases of patients with SPFS who had received SNS treatment were selected to observe SNS treating effect,summarize SNS nursing measures,and compare patients' clinical symptoms before and after the treatment.Results After a course of SNS treatment,12 cases out of 36 were cured,22 were better,2 were invalid,with the total efficiency rate of 94.4％.The symptoms including defecation incompletion feeling,difficult defecation,anal pain and anal obstruction were much better after the treatment than before,and the differences were statistically significant (x2 =26.972,22.500,56.933,40.500,respectively; P ＜ 0.01).Conclusions SNS has a definite effect on treating SPFS.Psychological nursing before therapy and health education after therapy are the key points for successful treatment.

OBJECTIVETo investigate the clinical effect of manshuailing oral liquid on patients with congestive heart failure of type heart and kidney Yang deficiency.

METHOD90 patients of heart failure were randomly divided into 2 groups. 45 cases in the routine treatment group (RT) received general therapy including diuretics and digitalis, and 45 cases in the Chinese herb medicine group (CH) were treated basically with the above medicine, with additional manshuailing oral liquid. The clinical effect was summarized 6 weeks after treatment.

RESULTTotal effect rate was 82.2% and 62.2% in CH and RTgroup respectively. Compared with pretreatment, heart function including stroke volume (SV), stroke volume index (SVI), cardiac index (CI), shorten rate of left ventricular short axe (deltaD%), distance of inter-ventricular septal to mitral valve (EPSS) were all improved significantly in both groups (P < 0.05 or P < 0.01), and with even better effects in the CH group than the RT group (P < 0.05 or P < 0.01), except the SV.

CONCLUSIONManshuailing oral liquid can alleviate clinical symptom, decreased EPSS, increase deltaD% and improve heart function.

Administration, Oral ; Adult ; Aged ; Cardiotonic Agents ; therapeutic use ; Combined Modality Therapy ; Diagnosis, Differential ; Digoxin ; therapeutic use ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; therapeutic use ; Female ; Heart Failure ; drug therapy ; physiopathology ; Heart Function Tests ; Humans ; Hydrochlorothiazide ; therapeutic use ; Isosorbide Dinitrate ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Plants, Medicinal ; chemistry ; Sodium Chloride Symporter Inhibitors ; therapeutic use ; Vasodilator Agents ; therapeutic use ; Yang Deficiency ; drug therapy

OBJECTIVETo establish a quantitative method for determination of synephrine and N-methyltyramine in Citri Reticulatae.

METHODSamples were extracted with 30% methanol. ODS column was used with methanol-water-sodium dodecyl sulfate (55:45:0.1) as mobile phase. Detection wavelength was 285 nm.

RESULTSynephrine and N-methyltyramine in sample solution were well separated. Linearity of synephrine was good (r = 0.9999) in range of 0.35-11.24 microg. The average recovery was 97.1%, and RSD of repeatability was 1.9%.

CONCLUSIONThis method can be used for quality control of Citri Reticulatae.

Chromatography, High Pressure Liquid ; Citrus ; chemistry ; Fruit ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Seasons ; Synephrine ; analysis ; Tyramine ; analogs & derivatives ; analysis

The Notch signaling pathway has been implicated in the regulation of cell-fate decisions such as differentiation of embryo stem cells and neural stem cells into neurons. We cultured human mesenchymal stem cells (hMSCs) in vitro and induced hMSCs to differentiate into neural cells by beta-mercaptoethanol (beta-ME), DMSO and 3-tert-butyl-4-hydroxyanisole (BHA). Immunocytochemistry was utilized to detect neuron-specific enolase (NSE) and Nissl body, and flow cytometry was used to determine cell growth phases. The expressions of signal molecules involved in the Notch pathway such as Notch1, Jagged 1 (JAG1), presenilin 1 (PS1) and hairy and enhancer of split 1(HES1) were observed by RT-PCR and immunofluorescent techniques. The results were as follows: (1) Before induction, the percentage of hMSCs at G(0)/G(1) was 58.5%, and the percentage at S+G(2)/M was 41.5%. After induction, the percentage of hMSCs at G(0)/G(1) increased to 73.1%, 76.2% and 78.1%, respectively on days 2, 4 and 6, and the percentage at S+G(2)/M decreased to 26.8%, 24.8% and 21.9%, respectively; The percentage of NSE-positive cells reached (77+/-0.35) %; Nisslos staining was positive in cytoplasm. (2) Notch1 and JAG1 were both expressed in hMSCs before and after induction, but the mRNA expressions of both Notch1 and JAG1, detected by RT-PCR, decreased obviously after induction(P<0.05). Notch1 mRNA/beta-actin was 1.157, 0.815, 0.756 and 0.570, and JAG1 mRNA/beta-actin was 0.437, 0.350, 0.314 and 0.362, respectively, on days 0, 2, 4 and 6 after induction. The Notch pathway activation participant PS1 mRNA and Notch pathway target gene HES1 mRNA also decreased apparently after induction (P<0.05), and their mRNA/beta-actin was 0.990, 0.449, 0.441, 0.454 and 0.370, 0.256, 0.266, 0.240 on days 0, 2, 4 and 6, respectively. These observations indicate that the expressions of Notch signal molecules were suppressed when hMSCs were induced to differentiate into neural cells. Based on these findings, we propose that low level of Notch signaling activation may contribute to neural cell differentiation.
Basic Helix-Loop-Helix Transcription Factors ; genetics ; Calcium-Binding Proteins ; genetics ; Cell Cycle ; Cell Differentiation ; Flow Cytometry ; Homeodomain Proteins ; genetics ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; Jagged-1 Protein ; Membrane Proteins ; genetics ; Mesenchymal Stromal Cells ; cytology ; Neurons ; cytology ; Receptor, Notch1 ; genetics ; Receptors, Notch ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Serrate-Jagged Proteins ; Signal Transduction ; Transcription Factor HES-1

To evaluate the safety and efficacy of intravitreal bevacizumab injection in patients with macular edema (ME) induced by retinal vein occlusion (RVO).
● METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for ME induced by RVO were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography ( OCT) and fundus fluorescein angiography ( FFA ), etc. Best corrected visual acuity (BCVA), intraocular pressure, the change of lens and vitreous, central foveal thickness (CFT) were observed at 1, 2, 3, 6mo after treatment and compared with before treatment. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. All the cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given at 6wk intervals.
●RESULTS: Fifty patients (56 eyes) with the average of (57±18. 56) years old were included. The mean baseline of BCVA, CFT were (logMAR0. 82±0. 63), (626. 5±178. 0)μm respectively. Although there was no significant decrease in mean CFT at 1wk after injection, the mean BCVA had significant improvement. Followed up at mean 10. 26 ± 5. 87mo, BCVA, CFT showed significant improvements over baseline values. The statistics of CFT at 1, 2, 3mo after injection were significant differences compared with before injection in each of the three groups. CFT at 1, 3, 12mo after injection were (365. 11±23. 212) μ m, (333. 42± 35. 526) μ m, (267. 6 ± 116. 8) μ m, which had a significant difference ( P < 0. 001), namely macular retinal thickness was thinner obviously that before treatment, ME was improved obviously. CFT was no significant difference at each time point after injection in the group of BRVO-ME and CRVO- ME (P> 0. 05). OCT image showed that after injection macular retinal thickness was becoming thinner. FFA showed that after injection macular fluorescein leakage decreased. BCVA was improved by at least two lines in 48 eyes (86%),remained stable in 8 eyes (14%) at the last visit. A total of 112 injections were performed and the average number of injections was 1. 96 in the group. About 50% of reinjections gained at least two lines of vision improvement at 1wk following the retreatment. There was no serious complications during the treatment.
●CONCLUSlON: lntravitreal injection of bevacizumab can improve visual acuity (VA) of RVO (CRVO and BRVO) in patients with ME, relieve ME, reduce the leakage of CNV, and repeated treatment is better. But a prolonged treatment effect needs further observation. There are no serious ocular and systemic complications occurred in our study.