Objective To evaluate the results of surgically treated Chiari Ⅰ malformation (CMI) with posterior fossa decompression and reconstruction techniques.Methods Sixty-nine patients with CMI malformation underwent posterior fossa reconstruction.The operation involes dissection soft tissue from the suboccipital region,decompression by removing the posterior rim of the foramen magnum.Then the dura was opened widely with Y shape,as it often acts as a constricting band,particularly at the level of the foramen magnum.After dissecting the subarachnoid adhesions in cisterna magna with microsurgery techniques,dissecting part of the tonsillar hernia,opening the foramen of Magendie into the 4th ventricle and closing the dura using artificial dura mater,cranial bone flaps was repositioned centrally along the inferior edge of the craniectomy defect,so as to support the dura over the cerebellar hemispheres.Results Until the final follow-up,the clinical symptoms were improved in 56 patients,3 had recurrence after 1 year postoperatived,4 had recurrenced after 2 years postoperatived,and 87.5％ patients were stable.The patients took followed-up MRI at least once form 3 months to 6 months,and 13 cases were lost.One case with tension pneumocephalus,and 5 cases with subcutaneous effusion and cerebro-spinal fluid (CSF) incision leakage.There were no death and disability.Thirty-one cases favors the development of syringomyelia,6 showed the stable of syringomyelia,and 2 had an increased size of the cavity.Conclusion Dissecting the subarachnoid adhesions in cisterna magna with microsurgery techniques,dissecting part of the tonsillar hernia,opening the foramen of Magendie into the 4th ventrica,and circulation of CSF pathway are important to improve thetherapeutic effect of CMI.It is also very important to decompression with small cranial bone flaps,closing the dura using artificial dura mater under no tension,and bone structure reconstruction in the clinical practice.

Objective To investigate the clinical application of 3.0 T mobile iMRI and neuronavigation in the microsurgical operation for the high grade gliomas in brain functional area.Methods The clinical data of 47 cases which were operated from April,2012 to August,2014 assisted by intraoperative magnetic resonance and neruonavigation system were analyzed retrospectively,including 19 cases of near the frontal motor areas,21 cases of closed to the dominant hemisphere language areas,and 7 cases of involved multiple lobes of the brain.The operative plans were made before the operative day using 3.0 T iMRI for T1-MPRAGE plain and enhancement magnetic resonance imaging sequence,diffusion tensor imaging (DTI) sequence and blood oxygenation level dependent functional MRI (BOLD-fMRI) sequence scanning.Before the start of operation,the margin of the tumor was marked on the scalp,and removed the tumor under the microscopy,according to the need 1-4 iMRI plain scan and enhanced scan were applied to reconstruct the real-time imaging of the residual tumors and corticospinal tract,and gained once more chances to remove the tumor repeatedly,until the tumor was removed totally,accurately and safely.Results The total resection rate increased from 63.8％ (30/47) to 95.7％ (45/47) by repeated resection,and 2 cases (4.3％ lesions) with subtotal resection.The dysfunction of motion and the language barrier got worse in 4 patients (8.5％).No cases with sever complication such as death and severe disability after operation.There were no intracranial hemorrhage,infection and other adverse events.Patients were followed up with nervous system symptoms and head MRI,the follow-up period was 3 months-2 years.Twenty-eight cases (59.6％) ob-tained good clinical efficacy;the dysfunction of motion and the language barrier got worse in 4 cases (8.5％);the symptoms and tumors recurrenced in 15 cases (31.9％).Conclusion The 3.0 T mobile iMRI system combined with functional neuronavigation can accurately display the relationships among the motor and language cortex,tumors and white matter fiber bundles real-timely.The extent of the tumor resection can be assessed accurately by real-time images provided by iMRI,and the residual tumor have chames to be resected repeatedly,until the tumors were resected totally before operation finished.The iMRI system can correct intraoperative brain shift timely.The total resection rate can be improved safely and accurately by one or more times resection.

OBJECTIVEIn this study, we aimed to investigate the expressions of adhesion molecules on human bronchial epithelial cells and neutrophils in co-culture system, assess the effects of puerarin on suppressing these adhesion molecules expressions, and explore the roles of two crucial signal-transduction elements p38 mitogen-activated protein kinase (p38 MAPK) and nuclear factor kappa B (NF-κB) in modulating adhesion molecules expressions.

METHODSNeutrophils and BEAS-2B cells (one human bronchial epithelial cell line) were co-cultured, and adhesion molecules expressions on cell surface were detected using flow cytometry. The mRNA levels of adhesion molecules were assessed by real-time quantitative polymerase chain reaction (real-time qPCR). Phosphorylated p38 MAPK and inhibitor κB were analyzed by Western blot.

RESULTSIn co-culture system, adhesion molecules expressions on BEAS-2B cells and neutrophils were enhanced significantly (P<0.05). Correspondingly, the mRNA levels of adhesion molecules were also increased greatly. Moreover, the pretreatment of peurarin obviously suppressed adhesion molecules expressions on cell surface. Furthermore, phosphorylated p38 MAPK and inhibitor κB in BEAS-2B cells and neutrophils were elevated in co-culture system, but decreased significantly after upon the treatment of peurarin (P<0.05).

CONCLUSIONSCoculture boosted the interactions between human bronchial epithelial cells and neutrophils mimicking airway inflflammation, whereas peurarin decreased the expression of adhesion molecules on cell surface by suppressing the activities of p38 MAPK and NF-κB pathways, and exhibiting its anti-inflflammation activity.

Animals ; Base Sequence ; Bronchi ; cytology ; enzymology ; metabolism ; Cattle ; Cell Adhesion Molecules ; metabolism ; Cell Line ; Coculture Techniques ; DNA Primers ; Down-Regulation ; drug effects ; Epithelial Cells ; enzymology ; metabolism ; Isoflavones ; pharmacology ; NF-kappa B ; metabolism ; Neutrophils ; enzymology ; metabolism ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo evaluate the clinical effect and safety of Tuina for treatment of somatic pain of sub-health.

METHODSA randomized, double-blind and blank parallel controlled trial was done. The experiment group was treated with Tuina and the control group lied down for rest, 45 minutes each time, twice each week for three weeks.

RESULTSTuina treatment could improve more on sensory, affective, evaluation, pain rating index and extant pain intensity of the pain index, and score of subjective sensation of life quality and health status together with physiology and psychology field of life quality.

CONCLUSIONMassage is an effective therapy for treatment of somatic pain of sub-health without adverse reactions and it should be generalized to application.

Adult ; Double-Blind Method ; Female ; Health Status ; Humans ; Male ; Massage ; Middle Aged ; Pain ; psychology ; Pain Management ; Quality of Life

OBJECTIVETo understand the information of female patients with knee osteoarthritis regarding muscle force, constitution parameter.

METHODSThirty-seven cases diagnosed as knee osteoarthritis and 37 controls were examined by MES. T-test was used to analysis two groups differences of muscle force, constitution parameter, et al.

RESULTSCompared between affected limbs and controls limbs in patients revealed that the lower limb muscle distribution index of the affected limbs was higher than the control limbs (P<0.05), but comparison in functional status the lower limb muscle force, muscle functional index and muscle force of unit volume of the affected limbs were lower than the control limbs (P<0.05). Compared between patients group and control group the muscle force of both lower limbs, muscle functional index and muscle force of unit volume were lower than control group (P<0.001).

CONCLUSIONThe utility muscle force of lower limbs of female patients with knee osteoarthritis is weaker than healthy female. Muscle function disorder instead of muscle atrophy is the key cause of the weakness.

Adult ; Aged ; Body Composition ; Case-Control Studies ; Female ; Humans ; Middle Aged ; Muscle Contraction ; Muscle, Skeletal ; metabolism ; physiopathology ; Osteoarthritis, Knee ; metabolism ; physiopathology ; Range of Motion, Articular

OBJECTIVETo investigate regulation function of anodonta glucan HBP-A on chondrocytes through Wnt pathway in vitro.

METHODSRat chondrocytes were cultured and differentiated induced with IL-1beta (10 ng/ml) in vitro. Chondrocytes were divided into five groups:IL-13 group,IL-1beta + IWP-2 (5 microM,Wnt pathway inhibitor) group, IL-1beta + HBP-A (0.3 mg/ml) group and IL-1beta + IWP-2 + HBP-A group. Wnt-3a, beta-catenin (24 h,48 h,72 h) and MMP-13(72 h) genes expression were detected by Rt-PCR, while beta-catenin, MMP-13, Sox-9 and coll-II (48 h) protein expression were measured by Western-blot.

RESULTSAfter induction of IL-1beta, gene expression of Wnt-3a, beta-catenin and MMP-13 were increased,so were the protein expression of beta-catenin and MMP-13. In contrast,protein expression of Sox-9 and Coll-II were declined. Following addition of HBP-A, Wnt-3a, beta-catenin and MMP-13 were shown as induction of IL-1beta, but protein expression of Sox-9 and Coll-II were upgraded. Combining HBP-A with IWP-2 led to the lowest level in Wnt-3a, beta-catenin gene and beta-catenin protein expression and highest expression of Sox-9 protein.

CONCLUSIONHBP-A could not only delay the differentiation of chondrocytes through downgrading the signal expression of Wnt/beta-catenin,but also adjust the expression of Wnt-3a, beta-catenin and Sox-9 when combinated with the Wnt inhibitor.

Animals ; Anodonta ; chemistry ; Cell Differentiation ; drug effects ; Cells, Cultured ; Chondrocytes ; cytology ; drug effects ; metabolism ; Glucans ; pharmacology ; Interleukin-1beta ; metabolism ; Rats ; Wnt Signaling Pathway ; drug effects ; Wnt3A Protein ; genetics ; metabolism ; beta Catenin ; metabolism

OBJECTIVETo evaluate the therapeutic effect of acupuncture-moxibustion and Tuina massage for treatment of sub-health.

METHODSA systematic evaluation on randomized controlled trial, quasi-randomized control trial or controlled clinical trial of treatment of sub-health with acupuncture-moxibustion and Tuina was carried out according to the assessment methods recommended by the Cochrane Collaboration.

RESULTSThere are totally 9 articles and 937 subjects met the inclusion criteria and are included into the assessment system. The average quality of methodologies adopted is not so high, and with many limitations. Meta-analysis or descriptive analysis on the data collected: (1) General effect: Tuina massage therapy is better than auricular-point-pressing therapy; acupuncture is better than self health care; acupoint injection is better than intramuscular injection, Tuina is similar to Chinese herb. (2) Quality of life and pain score: Tuina is better than blank control. (3) Individual effect: the effect of Tuina massage on lassitude is better than acupuncture. (4) Effect on sleep quality index: Tuina massage is better than acupuncture.

CONCLUSIONThere are not enough evidences to approve that the effect of acupuncture-moxibustion and Tuina massage on sub-health is better than that of other therapies. Therefore, more high quality randomized controlled trials with strict and scientific designation are necessary for obtaining more and better evidences.

Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Health Status ; Humans ; Massage ; Randomized Controlled Trials as Topic

OBJECTIVETo study the changes and significance of serum hydrogen sulfide (H2S) levels in children with benign infantile convulsions associated with mild gastroenteritis (BICE).

METHODSForty-two hospitalized children diagnosed with BICE were recruited to the observation group, and 46 children admitted due to acute gastroenteritis alone were recruited to the control group. Serum H2S levels were measured by a spectrophotometer.

RESULTSThe serum H2S level in the observation group was significantly lower than in the control group (28±12 μmol/L vs 45±10 μmol/L; P<0.01). The patients with a number of convulsions greater than or equal to two had significantly lower serum H2S levels than those with a number less than two (P<0.05). The number of convulsions was negatively correlated with serum H2S level in BICE patients (r=-0.485, P=0.001). When a convulsion exceeded 5 minues in duration, the duration was negatively correlated with serum H2S level (r=-0.736, P=0.004).

CONCLUSIONSThe reduction in endogenous H2S level might be one of the causes of convulsions in BICE patients. The degree of reduction in H2S level is associated with the number of convulsions and the duration of convulsion (when it exceeds 5 minues). Further investigation is needed to determine the clinical significance of these results.

Child, Preschool ; Female ; Gastroenteritis ; blood ; complications ; Humans ; Hydrogen Sulfide ; blood ; Infant ; Male ; Seizures ; blood ; etiology

OBJECTIVETo explore the diagnostic value of whole-organ magnetic resonance imaging score (WORMS) in knee osteoarthritis (KOA).

METHODSFrom November 2009 to January 2011,70 patients with KOA combined with knee effusion among outpatient and inpatient were analyzed retrospectively. Among the patients, 12 patients were male, 58 patients were female,ranging in age from 46 to 75 years,with a mean age of (59.66 +/- 9.93) years. The clinical symptoms were evaluated by WOMAC, the imaging of KOA was assessed by K-L score and WORMS, and COMP and CTX- II were measured respectively by ELISA. The correlation analyses and multiple linear regression analysis were studied to determine associations among biomarkers, clinical variables and radiographic findings of knee joints.

RESULTSThe average scores of WOMAC and WORMS were (57.50 +/- 8.20) and (64.54 +/- 16.45) respectively. The median of CTX- II nd COMP were 2.42 ng/ml and 4.56 ng/ml respectively. Grouped by less than the lowest quartile and more than the highest quartile of WORMS, COMP was significantly different (Z=2.04, P=0.039), but there was no significant difference in CTX-II (Z=0.79, P=0.427). WORMS were positively correlated with WOMAC and K-L score (r=0.777, P<0.01; r=0.716, P<0.01; respectively); WOMAC was also positively correlated with K-L score (r=0.692, P<0.01). WORMS's cartilage, osteophytes and synovitis were positively correlated with WOMAC, K-L score and COMP respectively (r=0.771, P<0.01; r=0.509, P<0.01; r=0.917, P<0.01). It was determined by stepwise regression that the KOA was mainly affected by WORMS, K-L score (P=0.015, P=0.025 respectively) when WOMAC as a dependent variable, age, gender, K-L score, WORMS, COMP and CTX- II as independent variables (F=20.327, P<0.01).

CONCLUSIONWORMS has a better reference value for diagnosis of KOA. The expression of COMP is high in the synovial fluid when WORMS at the high point. The clinical symptoms of knee osteoarthritis are mainly affected by WORMS and K-L score.

Aged ; Cartilage Oligomeric Matrix Protein ; Collagen Type I ; analysis ; Extracellular Matrix Proteins ; analysis ; Female ; Glycoproteins ; analysis ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Matrilin Proteins ; Middle Aged ; Osteoarthritis, Knee ; diagnosis ; metabolism ; physiopathology ; Peptides ; analysis

OBJECTIVETo observe the difference in the efficacy on lumbar intervertebral disc protrusion (LIDP) between Santong tuina therapy and conventional tuina therapy.

METHODSMulti-central, random and controlled clinical trial was carried out. One hundred and twenty cases of LIDP were randomized into an observation group and a control group, 60 cases in each one. In observation group, Santong tuina therapy was used. In control group, conventional tuina therapy was adopted. The clinical efficacy was observed in two groups, and lumbar vertebral function was scaled before and after treatment in two groups.

RESULTSThe total effective rate was 95.0% (57/60) in observation group and was 96.7% (58/60) in control group, without significant statistical difference in comparison (P > 0.05). The cured and markedly effective rate was 81.7% (49/60) in observation group and was 63.3% (38/60) in control group, indicating significant statistical difference in comparison (P < 0.05). The self-comparison of lumbar vertebral function before and after treatment presented statistical significance in either observation group (12.25 +/- 3.15, 25.56 +/- 5.27) or control group (13.32 +/- 3.26, 20.46 +/- 4.25, both P < 0.05); additionally, there was significant difference in the comparison between groups after treatment (P < 0.05). The therapy adopted in observation group improved lumbar vertebral function much significantly.

CONCLUSIONIn the treatment of LIDP, Santong tuina therapy achieves much better clinical efficacy as compared with conventional tuina therapy.

Adolescent ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Manipulation, Orthopedic ; methods ; Medicine, Chinese Traditional ; Middle Aged