ObjectiveTo evaluate the two common anesthesia techniques used in the hip joint replacement surgery (HJRS) and provide references to the most reasonable choice for them. MethodsTo undertake a retrospective study on 34 patients that received continuous epidural anesthesia(CEA) or combined intravenous and inhaled anesthesia(CIIA)respectively in HJRS. Results and Conclusions CEA had higher incidence of bone cement reaction than that of CIIA, whereas there was no significant difference in blood loss and the anesthesia efficacy between them. CIIA seemed to be easier to be performed. CIIA sounds more reasonable than CEA in HJRS although both of them are safe anesthesia techniques.

OBJECTIVETo study the roles of actin and transforming growth factor (TGF)-beta(1) in the injury repair and the development of emphysema.

METHODSWistar rats were randomly divided into two groups: the smoking and infection group (group SI) and the control group (group C). The rats of group SI received smoking irritation accompanying with repeated intranasal infection. Subgroups of the experimental animals were killed in the 2nd, 4th, 8th and 16th weeks respectively. The morphological changes of lungs were compared and PaO(2), PaCO(2) as well as the right ventricular systolic pressure (RVSP) were analysed. The lung sections were stained with immunohistochemistry for actin and TGF-beta(1).

RESULTSIn comparison with animals of group C, thickening of the bronchiolar walls, narrowing of bronchiolar lumens, and area of emphysema were much severe in animals of group SI (P < 0.05). The muscularization of intra-alveolar arteries in group SI in the 16th week was apparent in comparing with that in group C (P < 0.05). PaO(2) values in group SI were significantly decreased, and RVSP values in group SI were significantly increased in the 8th and 16th week (P < 0.05). Actin expression was increased in animals of group SI in the 4th and 8th week (0.24 +/- 0.06 and 0.25 +/- 0.05) in comparing with that of group C (0.09 +/- 0.03) (P < 0.05). Animals of group SI showed a significant increase of TGF-beta(1) in lung tissue in different periods as mentioned in above (33.33 +/- 12.11, 45.71 +/- 15.12, 71.43 +/- 16.76 and 86.25 +/- 20.66 respectively).

CONCLUSIONSThe increased expression of actin and TGF-beta(1) protein in small airways induced by smoking irritation and Klebsiella Pneumoniae may interfere with the repair response, and contributes to the development of emphysema.

Actins ; metabolism ; Animals ; Bronchi ; metabolism ; pathology ; Epithelial Cells ; metabolism ; Female ; Klebsiella Infections ; microbiology ; Klebsiella pneumoniae ; Lung ; pathology ; Male ; Pulmonary Disease, Chronic Obstructive ; metabolism ; microbiology ; Pulmonary Emphysema ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Smoking ; Transforming Growth Factor beta ; metabolism ; Transforming Growth Factor beta1

This study aims to analyze the molecular epidemiological characteristics of HIV-1 strains prevailing among men who have sex with men (MSM) in Beijing, China. The pol gene fragments from 250 newly diagnosed HIV-1-infected MSM individuals during 2006-2010 in Beijing were amplified by RT-nested PCR, sequenced, and phylogenetically analyzed. HIV-1 pol gene from 189 individuals were amplified and analyzed; 81 (42. 9%), 3 (1. 6%), 2 (1.0%), 88 (46. 6%), and 15 (7.9%) individuals were infected with HIV-1 subtypes B, B', C, CRF01_AE, and CRF07_BC, respectively. The subtypes B and CRF01_AE could both be grouped into two clusters, and CRFO7_BC strains shared high homology and were presumed to originate from a common ancestor. The HIV-1 circulating in MSM in Beijing had a lower genetic diversity than in heterosexuals. The HIV-1 epidemic (2006-2010) in MSM in Beijing was actually a rapid spread of HIV-1 CRF01 AE and B, or rather native strains of the two viruses.
Adult ; China ; epidemiology ; Epidemics ; Genetic Variation ; HIV Infections ; diagnosis ; epidemiology ; virology ; HIV-1 ; classification ; genetics ; isolation & purification ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; Molecular Sequence Data ; Phylogeny ; Young Adult

This case report we presented is that the anomalous left main coronary artery (LMCA) originates from the proximal segment of right coronary artery. In order to confirm the origin and course of the anomalous LMCA, a multi-slice computed tomography (MSCT) of the heart was performed on a 64-slice machine (Philips 64 Slice, Philips, USA) after 6 months of coronary angiography operation. The results showed that the anomalous LMCA originates from the proximal segment of right coronary artery, lies posteriorly to the aorta before taking acute sharply to go between the aorta and left atrium. It was classified as R-II P subtype according to Lipton’s classification. It is a rare case in the clinical practice.
Aged ; Coronary Vessel Anomalies ; diagnosis ; Coronary Vessels ; pathology ; Humans ; Male

OBJECTIVETo search for a better therapy for prolapse of lumbar intervertebral disk.

METHODSOne hundred and sixteen cases were randomly divided into a treatment group treated with round sharp needle plus massage, and a control group with filiform needle plus massage, 58 cases in each group. Changes of symptoms and signs were observed before and after treatment.

RESULTSThe effective rate was 98.2% in the treatment group and 82.8% in the control group (P < 0.01).

CONCLUSIONRound sharp needle combined with massage has a better therapeutic effect on prolapse of lumbar intervertebral disk.

Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; therapy ; Massage ; Needles ; Prolapse

Multiple myeloma is a malignant disease with high incidence in middle-aged and old-aged population. Bortezomib is a proteasome inhibitor which target mainly is NF-kappaB. This observation is to study the clinical treatment effect of bortezomib in one relapsed multiple myeloma (MM) patient and one primary refractory MM patient. The first patient diagnosed as IgA IIIA stage, whose state of disease became worse after 8 months of autologous peripheral blood stem cell transplantation. And the disease became further aggressive with 4 courses of chemical therapy regimen including methylprednisolone, Arsenic trioxide, dexamethasone, cyclophosphamide, mitoxantrone, VM-26. Myeloma cells in bone marrow and abnormal monoclonal immunoglobulin in blood plasma both increased. Bone destruction became severe, and there was a plasmacytoma about 5 x 6 cm on the patient's right upper chest wall. Therefore, the patient received therapy of bortezomib combined with doxrubicin, dexamethasone and thalidomide (VADT). After one course of therapy with this VADT regimen, IgA in blood plasma decreased from 54 g/L to 6.6 g/L, and abnormal plasma cells in bone marrow decreased from 40% to 0.6%, and plasmacytoma on the patient's right upper chest wall almost absorbed. But there was no obvious clinical effect after the second course of therapy of VADT, and the disease status became progressive again. The second patient was MM patient with a light chain kappa type, III B stage. There was no any effect after two courses of VAD therapy and one course of MOFP therapy. The patient acquired near complete remission after one course of treatment with VADT. Quantity of kappa protein in urine reduced from 24 - 30 g/24 hours to 1.12 g/24 hours. Blood creatinine reduced from 475.3 micromol/L to 124.2 micromol/L. Beta2-MG reduced from 161g/L to 64 g/L. And this patient got complete remission after three consecutive VADT therapy. The mainly side effects of the bortezomib regimen in the first patient include markedly lassitude, diarrhea, numbness of the end of extremities, marked increase of LDH. All the side effects could be tolerated and became disappeared after contraposing treatment and stopping the bortezomib regimen therapy. The second patient complicated with severe subacute left hemiplegia after the bortezomib dose had been increased to 1.45 mg/m2 at the third time of the first VADT course and the complication became worst at the following day. The upper limb muscle strength was only 1 grade and the lower limb muscle strength was 2 grade. Then the condition improved with the support therapy and gradually recovered after two weeks. Therefore, bortezomib is an effective target drug for therapy in refractory multiple myeloma, and more attentions to the side effects should be paid in order to deal with those side effects in time.
Adult ; Antineoplastic Agents ; therapeutic use ; Boronic Acids ; therapeutic use ; Bortezomib ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Neoplasm Recurrence, Local ; drug therapy ; Protease Inhibitors ; therapeutic use ; Pyrazines ; therapeutic use ; Salvage Therapy

Objective To understand the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis(SENEAS),and to verify the conclusion of previous studies,so as to provide the evidence for schistosomiasis monitoring in such areas in Nantong City,Jiangsu Province. Methods The controlled field tests were carried out to observe the O. hupensis snails artificially infected by schistosome miracidia in SENEAS. The influence of the soil from SENEAS and the en-demic areas on O. hupensis snails artificially infected by miracidia were observed. Results All the experimental snails could be infected by schistosome miracidia except the smooth-shell snails from Tangyuan Village in the controlled field test environment of SENEAS or the endemic areas. The infection rates of the smooth-shell snails were lower than those of the ribbed-shell snails , but there were no statistically significant differences. The mortality rates of the smooth-shell snails were higher than those of the ribbed-shell snails,which were statistically significant (χ2Xindian = 135.118,χ2Shuangdian = 122.836,χ2Baipu =154.436,χ2Dingyan =138.288,χ2Control=151.923,all P<0.01). There were no significant differences in the infection rates of snails between each test group of the soil from SENEAS and the endemic areas(χ2Rugao=0.071,χ2Rudong=0.216,both P>0.05). Also there was no signifi-cant difference between each test group and the control group without soil(χ2=7.148,P>0.05). Conclusion It is likely to form the spread of schistosomiasis in SENEAS in Nantong City with sufficient amount of infection source of schistosomiasis im-ported. It is still necessary to implement the surveillance of schistosomiasis and O. hupensis snails in Nantong City.

OBJECTIVETo provide morphological basis for chyle leakage due to operation on upper abdomen or retroperitoneum region.

METHODSThe original part of thoracic duct, cisterna chyle, intestinal trunk, left and right lumbar trunks were examined in 32 adult cadavers.

RESULTS(1) The occurrence rate of cisterna chili was 22% (7 cases), among which 4 cases were oval, 3 cases were triangle. The cisterna chyle was (24 +/- 6) mm in length; the width of middle part was (4.1 +/- 0.9) mm. It was located to the right of midline at the level between the twelfth thoracic vertebral body and the second lumbar vertebral body anteriorly. (2) The original part of thoracic duct was (2.8 +/- 0.7) mm in diameter. The confluence form of thoracic duct included: left lumbar trunk and intestinal trunk united to form the common trunk first, right lumbar trunk then joined the common trunk (9 cases, 36%); right lumbar trunk and intestinal trunk united to form the common trunk first, left lumbar trunk then joined the common trunk (8 cases, 32%); left and right lumbar trunk united to form the common trunk first, intestinal trunk then joined the common trunk (4 cases, 16%); left, right lumbar trunk and intestinal trunk joined together (3 cases, 12%). (3) The intestinal trunk was (36 +/- 15) mm in length. It ascended on the left of descending aorta, superior to the left renal artery, crossed the second lumbar vertebra anteriorly, and joined left or right lumbar trunk to form common trunk, which extended to the cisterna chili or thoracic duct to the right of lumbar vertebra. (4) The lengths of left and right lumbar trunks were (107 +/- 24) mm and (111 +/- 18) mm, the external diameters of origins were (1.7 +/- 0.4) mm and (1.9 +/- 0.4) mm, and the external diameters of terminations were (2.2 +/- 0.6) mm and (2.2 +/- 0.5) mm, respectively.

CONCLUSIONThe larger lymph tubes should be protected emphatically in the relevant region when dissecting the root of celiac and superior mesenteric artery and the termination of inferior mesenteric vein during abdominal operation.

Abdomen ; anatomy & histology ; Adult ; Female ; Humans ; Laparotomy ; adverse effects ; Male ; Thoracic Duct ; anatomy & histology

OBJECTIVETo prepare a neutralizing monoclonal antibody (McAb) against vascular endothelial growth factor receptor KDR and study its biological activity.

METHODSExtracellular immunoglobulin (Ig)-like domain III of KDR (KDR III) was expressed in E. coli and purified by affinity chromatograph. Monoclonal antibody against KDR III was prepared by hybridoma technique. ELISA and FACS analysis were used to identify its specificity. Immunoprecipitation and [(3)H]-TdR incorporation assay were also used to detect the activity of anti-KDR McAb blocking the phosphorylation of KDR tyrosine kinase receptor and the influence on VEGF-induced mitogenesis of human endothelial cells.

RESULTSMcAb Ycom1D3 against KDR III was prepared which bound specifically to both the soluble KDR III and the cell-surface expressed KDR. It effectively blocked VEGF/KDR interaction and inhibited VEGF-stimulated activation of KDR expression on human endothelial cells. Furthermore, Ycom1D3 efficiently neutralized VEGF-induced mitogenesis of human umbilical vascular endothelial cells.

CONCLUSIONMcAb Ycom1D3 against KDR III may suppress the action of VEGF by blocking native vascular endothelial growth factor receptor KDR. It has potential clinical applications in the treatment of cancers and other diseases where pathological angiogenesis is involved.

Antibodies, Monoclonal ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endothelial Cells ; cytology ; Humans ; Neovascularization, Physiologic ; Umbilical Veins ; cytology ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; immunology

OBJECTIVETo analyze 21 cases of rabies from February 8 to May 1 in 2004 in Anlong county in Guizhou province, and to explore the possible factors causing the epidemics.

METHODS21 cases of rabies were investigated. The canine brains were collected, and indirect immunofluorescence assay was used to detect rabies virus antigen in the brains.

RESULTSFrom February 8 to May 1st in this year, 21 cases of rabies were reported, with 5.12/100,000 of the prevalence rate. Dogs accounted for 20 cases, and cat for one case. Median incubation period was 36.52 days, but less than 15 days in 6 cases. Among 21 cases, 17 cases were not correctly treated, and 9 cases received vaccine, with 3 cases vaccinated in time. No cases received passive immunization of antirabies serum or human antirabies immune globulin. A total of 73 dogs' brains were examined for rabies viral antigen by IFA, and 9 (12.33%) were positive.

CONCLUSIONThe increasing number of dog, high rate of virus carrier in dogs, incorrect treatment of the wound, and as well as low inoculating rate of rabies vaccine might be responsible for the outbreak of rabies in Anlong county.

Adolescent ; Adult ; Child ; China ; epidemiology ; Disease Outbreaks ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Rabies ; epidemiology ; Rabies Vaccines ; immunology ; Rabies virus ; immunology ; isolation & purification ; Vaccination