Diagnosis, Differential ; Humans ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; SARS Virus ; genetics ; Sequence Analysis, DNA ; Severe Acute Respiratory Syndrome ; diagnosis ; virology

Objective To investigate the clinical effectiveness of coronary artery bypass grafting through descending thoracic aorta in elderly patients with coronary heast disease and to decrease the post-operative complication.Methods Thirteen elderly patients underwent coronary bypass surgery with minimally invasive direct coronary artery bypass (MIDCAB).Age range from 70 to 82 years with a mean of(72.1?6.0)years.Patients suffered from multi vessel disease.Many minimally invasive techniques of“Y”blood vessel graft anastomosis,anastomosis of blood vessel graft to descending aorta,minimally invasive direct,thoracoscope assist were used.Results All patients were survived.The mean duration of intubation was (6.9?0.9) hours.The average ICU stay was (2.5?0.5)days.No patients received blood transfusion.During the short-term follow-up(3 to 14 months) patients had no complaint of angina,Conclusions The technique of“Y”blood vessel graft anastomosis,descending aorta blood vessel graft,minimally invasive direct and thoracoscope assist in combination with coronary artery bypass grafting is a safe and cost-effective new procedure for elderly patients with multi-coronary artery disease.

OBJECTIVETo evaluate therapeutic effect of the needle-knife closed solution combined with minor adjusting of spine for treatment of neck-shoulder syndrome.

METHODSFrom April 2010 to August 2011,120 patients with neck-shoulder syndrome were treated with the needle-knife closed solution combined with minor adjusting of spine, and included 45 males and 75 females and aged from 40 to 68 years old. The disease course was from 3 days to 10 years. After the operation, all patients taken the medicine of activating blood circulation herbs. At the 3rd, 7th, 10th day after operation, spinal rotation massage was performed on these patients. After the healing of the needle points, traditional Chinese medicine herb fumigation was applied on the needle points, and the patients were directed to do the cervical spine exercise. Therapeutic effect of the patients was evaluated by the neck disability index (NDI).

RESULTSAll patients were followed up after 3 weeks' treatment. The pain of neck-shoulder was relieved, and the range of motion was improved,the NDI score lowered from 49.30 +/- 1.35 before treatment to 10.15 +/- 1.18 at 3 weeks after treatment (t = 2.116, P < 0.05).

CONCLUSIONThe needle-knife closed solution combined with minor adjusting of spine for the treatment of neck-shoulder syndrome can relieve the pain in the neck-shoulder and improved the motion of the neck. The key for the effect is accurate location before operation, sufficient adhesion solution during the operation and spinal minor adjusting after operation.

Adult ; Aged ; Female ; Humans ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Myofascial Pain Syndromes ; therapy ; Neck Pain ; therapy ; Shoulder Pain ; therapy

To introduce scientific research innovation into undergraduate education, cultivating innovative talents has been an urgent mission of current higher education. This article reviewed our experience, with the introduction of producing-studying-researching platform built on original innovative achievements of Chongqing medical university,of training physical medicine physician to be practical talents of large-scale diagnostic and therapeutic medical equipments, and was aimed to explore introducing producing-studying-researching platform into undergraduate education as well as improve personnel training quality of undergraduates.

Objective To investiagte the serum adiponectin concentration in preeclampsia and its relationship with serum leptin and soluble leptin receptor levels.Method The level of adiponectin,leptin and soluble leptin receptor in serum were measured by enzyme-linked immunosorbent assay(ELISA)in 38 patients with preeclampsia and 42 patients as control.The relationship of free leptin index(leptin/soluble leptin receptor) to preeclampsia was analyzed.Results There were no significant differences in maternal age,gestational age and body mass index(BMI)between two groups.But the gestational age and birth weight were significantly lower in preeclampsia than in control.The patients with preeclampsia had significantly higher levels of serum adiponectin, leptin and free leptin index(1691.7?g/ml,37.5 ng/ml and 0.95 respectively)than the control(689.4?g/ml, 19.3 ag/ml and 0.49,respectively).But there was no significant difference in serum level of soluble leptin receptor between the groups(35.0 ng/ml vs 42.2 ng/ml).Serum adiponectin was not significantly correlated with the level of leptin,soluble leptin receptor and free leptin index.Area of serum adiponectin,leptin and free leptin index in preeclampsia under the ROC curve were less than 0.5.Conclusions The patients with preeclampsia have paradoxical higher serum levels of adiponecfin and more bioavailability of leptin,suggesting these may be important factom of this complication.

Objective To evaluate the efficacy and safety of the interventional techniques for emergent treatment of iatrogenic renal injuries.Methods Nine patients with iatrogenic renal vascular injuries were treated with superselective renal arterial embolization.The causes of renal injury included post-renal biopsy in 5 patients,endovascular interventional procedure-related in 2,post-renal surgery in 1,and post-percutaneous nephrostomy in 1 patient.The patients presented clinically with hemodynamical unstability with blood loss shock in 7 patienrs,severe flank pain in 7,and hematuria in 8 patients.Perirenal hematoma was confirmed in 8 patients by CT and ultrasonography.The embolization materials used were microcoils in 7 and standard stainless steel coils in 2 patients,associated with polyvinyl alcohol particles(PVA)in 5,and gelfoam panicles in 2 cases.Results Renal angiogram revealed intra-renal arteriovenous fistula in 6 cases,intrarenal pseudoaneurysm in 2 cases,and the contrast media extravasation in 1 patient.The technical success of the arterial embolization was achieved in all 9 cases within a single session.All angiographies documented complete obliteration of the abnormal vessels together with all major intrarenal arterial branches maintaining patent.Seven patients with hemodynamically compromise experienced immediate relief of their blood loss related symptoms,and another 7 with severe flank pain got relief progressively.Hematuria ceased in 8 patients within 2-14 days after the embolization and impairment of renal function occurred after the procedure in 5 cases,including transient aggrevation(n=3)and developed new renal dysfunction(n=2).Two of these patients required hemodialysis.Perirenal hematoma were gradually absorbed on ultrasonography during 2-4 months after the procedures.Follow-up time ranged from 6-78 months(mean,38 months),4 patients died of other primary diseases of renal and multi-organ failures.Five patients are still alive without further intervention,and suffering no more of rebleeding and deterioration of renal function.Conclusions Transcatheter selective renal arterial embolization is safe and effective in the treatment of iatrogenic renal vascular injuries,resulting in permanent cessation of bleeding.(J Intervent Radiol,2007,16:807-810)

Objective To discuss the frequent etiology of spontaneous sub-cortical hemorrhage and its diag- nosis.Methods The clinical materials of 79 cases of spontaneous sub-cortical hemorrhage were analyzed.Results 56% of the hemorrhage was caused by arterial-venous malformation.48% of the hemorrhage was caused by occult AVM.Conclusion AVM is the most frequent etiology of spontaneous sub-cortical hemorrhage.CTA plays a special role in its diagnosis.

Objective To describe the manifestations of the inferior phrenic arteries(IPA)supply to the pulmonary hemorrhagic lesions and to evaluate the safety and efficacy of transcatheter arterial embolization(TAE)of the IPA.Methods The clinical data and imaging findings of eighteen patients with the additional blood supply to the pulmonary hemorrhagic lesions from the IPA were evaluated retrospectively.The causes of the bleeding were lung malignancies in 9,bronchiectasis in 7,and chronic inflammation in 2 patients.TAE supplementally was performed in patients with IPA supply to the pulmonary lesions,using polyvinyl alcohol particles,gelatin sponge particles,and microcoils.Results Selective arteriogram demonstrates an enlarged IPA,with numerous branches and hypervascularity in all 18 cases, with tumor staining in 9,the contrast material extravasation in 6,and non-specific staining in 2 cases.In addition,IPA-to-pulmonary shunting was found in 9 cases.All the lesions supplying by IPA were adjacent to the pleurae,including adjacent to the diaphragmatic pleura in 11,the mediastinal pleura in 5,and the lateral pleura of the lower lobe in 2 cases.Technical success of IPA embolization was achieved in the 18 cases.Embolization of other nonbronchial systemic arteries(the internal thoracic artery in 7 and intercostal artery in 3)was performed at the same session.All bleeding ceased immediately after supplemental IPA embolization.Follow-up time ranged from 8 months to 4 years.Mild recurrent hemoptysis occurred in 3 patients at 1,2,6 months respectively,after the embolization.These patients were responsive to conservative management.Recurrent bleeding did not occur in 15 patients during the follow-up. Conclusion The pulmonary hemorrhagic lesions,especially adjacent to the diaphragmatic and mediastinal pleurae,can be supplied by IPA,and may result in clinical failure following BAE.Supplemental TAE of IPA is a safe and effective adjunct to BAE in the management of bronchial bleeding supplied by IPA.

ObjectiveTo observe the protective effect of extract from Morindae officinalis on the oxidative injury of human sperm motility.MethodsThe sperm specimens were cultivated in vitro, the reactive oxygen species (ROS) was made from hypoxanthine-xanzine xanzine (HX-XO), and sperm specimens were co-incubated with ROS and different dosages of extract and oxygen. The motor parameters were evaluated, the motility were analyzed by the test of capillary tube penetrating, and compared with the control group.ResultsThe sperm function were injured, the motility and penetrating ability decreased evidently under the action of ROS, and with a significant difference compared with the normal group ( P<0.001). The sperm motility and penetrating ability could be improved by all of the small, medium and massive extract compared with vitamin C, especially 0.25 and 0.5 g/ml Morindae officinalis had more evident action in the rate of progressive motility and vitality exponent.ConclusionThe ROS can injury the sperm motility and penetrating ability, the appropriate content of extract from Morindae officinalis can significantly intervene peroxidation in sperm by the ROS, and protect the sperm motility.

OBJECTIVETo study the distribution of mutations of UDP-glucuronosyltransferase 1A1 (UGT1A1) gene and its relationship with hyperbilirubinemia among neonates with hyperbilirubinemia of Guangxi Heiyi Zhuang nationality.

METHODSTotal genomic DNA was extracted from the blood of 100 neonates with hyperbilirubinemia (case group) and 100 neonates without hyperbilirubinemia (control group), all of whom were selected from Guangxi Heiyi Zhuang population. TATA box and all exons of UGT1A1 gene were amplified by PCR and directly sequenced.

RESULTS(TA)7 insertion mutation in TATA box, G71R missense mutation in exon 1, and 4 single nucleotide polymorphisms (SNPs) (rs199539868, rs114982090, rs1042640 and rs8330) in exon 5 were observed. The allele frequency of G71R mutation in the case group was significantly higher than that in the control group (P<0.01). There were no significant differences in the genotype distribution and allele frequency of TATA box mutation and SNPs (rs1042640 and rs8330) between the two groups (P>0.05). The logistic regression analysis showed that the odds ratios (95% confidence intervals) of UGT1A1 TATA box mutation, G71R mutation, and SNPs (rs1042640 and rs8330) associated with the development of neonatal hyperbilirubinemia were 0.846 (0.440, 1.629), 3.932 (1.745, 8.858), 0.899 (0.364, 2.222), respectively.

CONCLUSIONS(TA)7 insertion mutation and G71R missense mutation of UGT1A1 gene are common mutation types in neonates with hyperbilirubinemia of Guangxi Heiyi Zhuang nationality. Four SNPs (rs199539868, rs114982090, rs1042640, and rs8330) was first reported in China. UGT1A1 G71R missense mutation is a risk factor for hyperbilirubinemia in neonates of Guangxi Heiyi Zhuang nationality.

China ; ethnology ; Glucuronosyltransferase ; genetics ; Humans ; Hyperbilirubinemia, Neonatal ; genetics ; Infant, Newborn ; Logistic Models ; Mutation ; Polymorphism, Single Nucleotide ; TATA Box