Objective To summarize the experiences in the diagnosis and treatment of delayed rupture of spleen.Methods The clinical data of 26 patients with traumatic delayed rupture of spleen who were admitted to the Dachang Hospital from January 2005 to December 2013 were analyzed retrospectively.The medical history,clinical presentation,results of laboratory examinations were analyzed,and the splenic trauma was graded.Surgical procedures were selected according to the condition,severity of the splenic trauma and time of injury.Patients were followed up via outpatient examination or telephone interview till June 2014.Results Twenty-six patients had the history of injury of the left hypochodriac region,and were accompanied by slight abdominal pain and a short period of pain alleviation,and then pain in all regions of the abdomen at postoperative hour 48.All thepatients had pale face,tenderness,rebound tenderness or tonus.The pulse above 100 per minute was observed in 20 patients,and 15 patients had blood pressure under 90/60 mmHg (1 mmHg =0.133 kPa).The level of hemoglobin under 5 g/L was observed in 3 patients,and 5-10 g/L in 21 patients.All the 26 patients received abdominal paracantesis,non-coagulating blood was extracted in 25 patients.Twenty-six patients received B ultrasonography,and 24 had splenic rupture.Nineteen patients received computed tomography (CT),and 19 had splenic rupture.Ten patients had type Ⅰ splenic rupture,12 had type Ⅱ splenic rupture,3 had type Ⅲ splenic rupture and 1 had type Ⅳ splenic rupture.All the 26 patients received operation,including 2 received suture of the ruptured spleen,2 received resection of the lower part of the spleen,9 received total splenic resection,and 13 received total splenic resection + autogeneous transplantation of greater omentum.Two patients died of hemorrhagic shock intraoperatively,and the other 24 patients were cured.The operation time and volume of hemoperitoneum were (90 ± 15)minutes and (1 500 ± 700) mL,respectively.Twenty-four patients received blood transfusion,with the volume of transfused blood of 1 200 mL.The mean duration of hospital stay was 16.7 days.Two patients had complications after the operation,which were left pleural effusion and splenic fossa effusion,and they were cured by symptomatic treatment.No infection or other complications were observed.All the 24 patients were followed up for 6-108 months (median,46 months).One patient died of myocardial infarction at postoperative year 5,and the other 23 patients survived.Conclusions B sonography and computed tomography are important methods for the treatment of delayed rupture of spleen.Traumatic delayed rupture of spleen should be considered when the patient had symptoms including history of injury of the left hypochondriac region,the course of abdominal pain,abdominal pain alleviation,abdominal pain recurrence,time for abdominal pain alleviation longer than 48 hours,interperitoneal hemorrhage and the signs of splenic rupture indicated by B ultrasonography and computed tomography.The indication of spleen-preservation surgery or splenectomy for patients with delayed rupture of spleen should be strictly controlled and optimal surgical procedure should be designed according to the condition of the patient.

Objective To explore the clinical characteristics,misdiagnosis reason,diagnosis and treatment of primany small intestinal tumor.Methoed Retrospective analysis of the clinical data were made on 40 cases of primary small intestinal tumors.Results Before operation,13 cases were given confirmed diagnosis of small intestinal tumor.The rate of misdiagnosis was 67.5％ (27/40).Partial excision were administered in 10 cases with benign small intestinal tumor.Adical excaision were performed in 24 cases with malignant tumors,palliative excision in 3 cases and shortcut operation in 3 cases.One patient died after opreation.Conclusions Before operation,the misdiagnostic rate of primary small intestinal tumor is high.Fiber endoscopy and X-ray may bring a high diagnostic rate of small intestinal tumor.

Objective To determine the content of octopamine,a kind of ?3-adrenergic receptor agonists in edible part of various fresh water and seawater aquatic products,and provide data for exploitation and utilization of octopamine in aquatic products.Methods After homogenate and ultrasound treatment,edible parts of fish,shellfish and cephalopodium were centrifugalized,then octopamine content in supernatant liquid was detected with HPLC.Results In eight kinds of fresh water fish,the octopamine contents of dorsal meat were generally higher than abdominal meat,which were in the range of 30~130?g?g-1 and roughly similar to seawater fish and freshwater shellfish.The octopamine contents in seawater shellfish were particularly high,almost dozens even thousands times of those in fish and freshwater shellfish.Cephalopodium also had a high content of octopamine while it was not detected in ocean algae.Conclusion Seawater mollusks are the most affluent resource of octopamine in aquatic products and ideal food of weight-watchers and diabetics.

Objective To study the inactivation kinetics and injury mechanism of Escherichia coli under UV disinfection in drinking water.Methods The inactivation kinetics of E.coli ATCC 25922 was determined by plate count methods in the UV disinfection experiment.The morphology,cell membrane permeabilization and injury of biological macromolecules were observed under a transmission electron microscope (TEM).The rate of ONPG hydrolysis and changes in activities of antioxidant enzymes were observed Raman spectroscopy.Results the changes of damaged cells involved morphological damage such as loss of the structural integrity of the wall and membrane,condensation of cellular material and leakage of significant amounts of cytoplasmic material,a more than four-fold increase of cell membrane permeabilization and damage to the structure of protein,nucleic acids and phospholipid.Conclusion UV disinfection can lead to a multi-target damage.

To explore the effects of protocatechuic acid (PCA) and its derivants on angiogenesis of the chick embryo chorioallantoic membrane (CAM) and scavenging DPPH radical in vitro. The protection of benzyl and alkaline hydrolysis of benzyl ester were employed. The structures of PCA-1, PCA-2 and PCA-3, the derivates of PCA, were elucidated by 1H, 13C-NMR and MS data The bioactivity of PCA and its derivants was evaluated on the models of DPPH radical and chick embryo chorioallantoic membrane (CAM), respectively. PCA and PCA-1 showed the best activity of scavenging DPPH radical among all the compounds. In contrast to PCA-2, PCA and PCA-3 displayed inhibition to angiogenesis (P < 0.001). Pyrocatechol hydroxyl is the active site of PCA on scavenging DPPH radical in vitro. PCA with carboxyl and without pyrocatechol hydroxyl seems to show promotion to angiogenesis, but it needs more evidences.
Angiogenesis Inducing Agents ; antagonists & inhibitors ; chemistry ; Animals ; Biphenyl Compounds ; Catechols ; chemistry ; Chick Embryo ; Chorioallantoic Membrane ; drug effects ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Free Radical Scavengers ; chemistry ; Hydroxybenzoates ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Picrates

OBJECTIVETo identify the mutation spectrum and the distribution of minihaplotypes (STR/VNTR) of phenylalanine hydroxylase (PAH) gene and explore the correlations between genotype and phenotype of patients with phenylketonuria (PKU) in Beijing area of China.

METHOD(1) Fifty cases with PKU were involved in this study. PKU was identified by the Neonatal Screening Center of Beijing. All 13 exons and their flanking intronic sequences of PAH gene of these patients were amplified and then subjected to SSCP analysis and direct sequencing. (2) The distribution of polymorphic locus of short tandem repeat (STR) and variable number tandem repeat (VNTR) was analyzed by PCR and denaturing gel electrophoresis. (3) The correlations between genotype and phenotype were studied by analysis of the matching rate between the expected and observed phenotypes. The predicted phenotype was determined on the basis of the sum of the assigned values of the two mutant alleles.

RESULTS(1) A total of 34 different mutations were detected with the relative frequency of 95% among 50 PKU patients. The prevalent mutations in this study were: R243Q (20%), EX6-96A > G (11%), Y356X (9%), and V399V (7%). The next common mutations were R111X (5%), R413P (5%), R252Q (3%) and A434D (3%). Thirty-four detected mutations were distributed throughout the whole PAH gene, except exon 1, 8 and 13. Exon 7 and 11, with the mutant rate 34% and 19% respectively, seemed to be the hot mutant areas/regions of PAH gene. (2) The minihaplotypes (STR/VNTR) of 34 mutations were identified in this research. The STR and VNTR showed 8 and 3 alleles, respectively. Among them, 244 bp (44%) and 240 bp (34%) were the prevalent STR alleles. Meanwhile, the VNTR3 (83%) was the most common VNTR allele in PKU patients. (3) A better consistency (81.5%) between expected and observed phenotypes was revealed by analysis of correlation between genotype and phenotype. Especially in classic PKU, the consistency rate was up to 87.5%.

CONCLUSION(1) The frequency distribution of common PAH gene mutations in Beijing region was close to that of Tianjin and Yunnan regions, while it was different from that of Southern regions of China, such as Guangzhou, especially Taiwan. The PAH mutation with a highly heterogeneous trait was also demonstrated in this study. (2) STR and VNTR minihaplotype will prove helpful to trace the origins of PAH mutations and to analyze the genetic drift. However, the most minihaplotypes of the STR/VNTR are similar, so it is necessary to associate some other polymorphic loci with the STR/VNTR minihaplotype to analyze the different mutations. (3) The fact that a better consistency existed between phenotypes and genotype with most PKU patients suggested that the study of the genotype of PKU patients would be helpful to the individualized treatment and to genetic counseling for their families.

Alleles ; China ; epidemiology ; Genetic Association Studies ; Genotype ; Humans ; Infant, Newborn ; Introns ; Mutation ; Phenotype ; Phenylalanine Hydroxylase ; genetics ; Phenylketonurias ; epidemiology ; genetics ; Polymorphism, Genetic

Tetramethylpyrazine (TMP), an effective component of traditional Chinese medicine Chuanxiong, is commonly used to resolve embolism. Its possible therapeutic effect against atherosclerosis has received considerable attention recently. Angiotensin II (Ang II) is highly implicated in the proliferation of vascular smooth muscle cells (VSMCs), resulting in atherosclerosis. The mechanisms of TMP in the proliferation of VSMCs induced by Ang II remain to be defined. The present study was aimed to study the effect of TMP on Ang II-induced VSMC proliferation through detection of nuclear factor-kappaB (NF-kappaB) activity and bone morphogenetic protein-2 (BMP-2) expression. Primary cultured rat aortic smooth muscle cells were divided into the control group, Ang II group, Ang II + TMP group and TMP group. Cells in each group were harvested at different time points (15, 30 and 60 min for detection of NF-kappaB activity; 6, 12 and 24 h for measurement of BMP-2 expression). NF-kappaB activation was identified as nuclear staining by immunohistochemistry. BMP-2 expression was observed through Western blot, immunohistochemistry and in situ hybridization. The results showed that: (1) Ang II stimulated the activation of NF-kappaB. Translocation of NF-kappaB p65 subunit from cytoplasm to nucleus appeared as early as 15 min, peaked at 30 min (P<0.01) and declined after 1 h. (2) TMP inhibited Ang II-induced NF-kappaB activation (P<0.01). (3) Ang II increased BMP-2 expression at 6 h but declined it significantly at 12 and 24 h (P<0.01). (4) BMP-2 expression was also kept at high level at 6 h in Ang II + TMP group but maintained at the normal level at 12 and 24 h. (5) There was no significant difference in NF-kappaB activation and BMP-2 expression between the control group and TMP group. These results indicate that TMP inhibits Ang II-induced VSMC proliferation through repression of NF-kappaB activation and BMP-2 reduction, and BMP-2 expression is independent of the NF-kappaB pathway. In conclusion, TMP has therapeutic potential for the treatment of atherosclerosis.
Angiotensin II ; antagonists & inhibitors ; Animals ; Atherosclerosis ; drug therapy ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; analysis ; antagonists & inhibitors ; Immunohistochemistry ; Muscle, Smooth, Vascular ; cytology ; drug effects ; metabolism ; Myocytes, Smooth Muscle ; metabolism ; NF-kappa B ; analysis ; antagonists & inhibitors ; Pyrazines ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta ; analysis ; antagonists & inhibitors

Objective To investigate the treatment status of antiparkinsonism in Xi'an. Methods Six general hospitals were randomly chosen in Xi' an and all Parkinson' s disease (PD) patients were interviewed by questionnaire from Jan. 2007 to Apr. 2007. Results 92 PD outpatients were enrolled in, including 48 males and 44 females, from 43 to 86 years old (mean 65.6±17.1) with duration of the disease from 0.2 to 27.8 years (mean 4.4 ±9.4). The preference of the drug use from the patients were: 40 (43.5%) preferred taking levodopa, 25 (27.2%) with amantadine and/or trihexyphenidyl, 14(15.2%) with levodopa and others, 4(4.4%) with dopamine agonist and others, 2 (2.2%) with other drugs, 7 (7.6%) with no treatment. There were 69 (75.0%) patients onset with resting tremor, 15 (16.3%) with bradykinesia, 6 (6.5%) with rigidity, and 2 (2.2%) with unknown symptoms. There was no startically significant difference in anti-PD drugs among the patients onset with different symptoms (P>0.05). 45 patients appeared the onset of disease before 65 years old and with no dementia, 47 onset after 65 with or without dementia. There was no significant difference of anti-PD drugs between the two groups (P>0.05). Most patients initiated anti-PD treatment with levodopa but few of them chose dopamine agonist. According to the classification of Hoehn & Yahr, 25(27.2%) belonged to Grade Ⅰ, 53(57.6%) to Grade Ⅱ ,8(8.7%) to Grade Ⅲ ,3(3.3%) to Grade Ⅳ and 3 (3.3%) to Grade Ⅴ. There was no significant differences of anti-PD drugs between different grades of the disease (P>0.05). 55.3% of the patients changed their anti-PD drugs randomly during the therapy, but with no relation to their gender, age, educational level, dementia, the number of family members, course of diseases, or the degree of Hoehn & Yahr, frequency and categories of medicine. Conclusion Anti-PD treatment in Xi' an did not strictly follow the standardized protocol, with few patients using dopamine agonist and over 50% of the patients changed their drugs randomly.

OBJECTIVETo explore the incidence of dementia among elderly people in Xi'an and its related risk factors.

METHODSSubjects that had been studied on the prevalence of dementia were follow-up, and the incidence of dementia, Alzheimer disease (AD) , and vascular dementia (VD) were counted by person-years. The clinical diagnosis on dementia,AD and VD were based upon the 3rd Edition of Diagnostic and Statistical of Manual of Mental Disorder, Revised version (DSM-III-R) and NINCDS-ADRDA criteria.

RESULTS2197 subjects of non-dementia being identified in 1998, were re-surveyed in 2001. Out of them, 47 new cases of dementia including 37 cases of AD and 8 cases of VD were identified, with an annual incidence rates of dementia, AD and VD as 0.68%, 0.54% and 0.12% among those of 55 years and over and 0.89%, 0.69% and 0.17% in 65 years and over, respectively. Analysis from single factor logistic regression showed that age and education but not gender were closely related to the occurrence of AD. On the contrary, age, hypertension and stroke were closely related to the occurrence of VD.

CONCLUSIONThe incidence of dementia in the "Xi' an cohort" was similar to that being reported from other countries. AD and VD were an age-related diseases but education seemed to have had great protective effect while lack of formal education served as risk factor to AD.

Age Distribution ; Aged ; Aged, 80 and over ; China ; epidemiology ; Dementia ; classification ; epidemiology ; Educational Status ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Sex Distribution

Metabonomics, a new and rapid-developing technology, will be powerful means to the research of complexed theory system and modernization of traditional Chinese medicine (TCM). Discovery of biomarkers and analysis of common properties from the metabolome of a specific TCM syndrome will facilitate the modernized study of TCM system, promote the quantitative and scientific elucidation of TCM syndrome differentiation, provide an in-depth understanding of the TCM theory of Zang-xiang, help predict the disease on-set, and achieve a comprehensive evaluation of systemic clinical efficacy, safety and mechanism of action of the TCM combination formulas along with a better understanding of intestinal microflora ecology. The new approach with combined metabonomics and TCM methodologies will provide a new pathway and methodology for the study of complicated theory system of TCM and its modernization.
Biomarkers ; analysis ; metabolism ; Diagnosis, Differential ; Homeostasis ; Humans ; Medicine, Chinese Traditional ; methods ; Metabolism