[Objective] To observe imaging changes of Lumbar Intervertebral Disc Protrusion(LIDP)treated by Leverage Location manipulation.[Methods] 33 patients with lumbar intervertebral disc protrusion were observed(male=19,female=14),4 cases of expand type,25 cases of the outstanding type,4 cases of the free type.Using lever to observe the CT imaging of the cases.[Results]The 24 cases had no change in degree of Intervertebral Disc Protrusion while 9 cases had the changes.29 cases changed the compression relation between the nerve root and the lumbar intervertebral protrusion.Another 4 cases had nothing changed.[Conclusion] Leverage location manipulation has a little effect on changing the degree of the lumbar intervertebral protrusion,but can change compression relation between the nerve root and the lumbar intervertebral protrusion which proves that leverage location manipulation has effect on curing the LIDP.

Objective To study the technology of flocculation of water-extraction solution in Lonicerae Japonicae Flos by uniform design method.Methods The liquid concentration ratio, chitosan dosage, temperature and pH were studied with the ratio of the precipitation and the rate of the transformation of valid target as index.Results The optimal flocculation process was: dosage of chitosan was 0.14%, pH was 6, the concentration of the solution was 1:3 and the temperature was 30℃.Conclusions The effect of purification is good, and the flocculation process can replace the traditional precipitation process.

Objective To investigate the association between single nucleotide polymorphism (SNP) of interleukin-12 (IL-12) p40 3'untranslated region rs3212227 site and hepatitis C virus (HCV) infection. Methods Patients with hepatitis C (n=127) were genotyped and analyzed for the SNP of IL-12 p40 rs3212227 using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing. The serum HCV RNA levels of patients with hepatitis C were detected using real time fluorescence quantitative-polymerase chain reaction (FQPCR). Inter-group comparisons of genotype and allele frequency were analyzed using chi-square test.Results In patients with hepatitis C, the frequencies of AA, AC and CC genotypes of IL-12 p40 rs3212227 site were 34. 6% ,40. 9% and 24. 4% , respectively,and the frequencies of allele A, C of IL12 p40 rs3212227 site were 55.1% and 44. 9%, respectively. The frequency of rs3212227 C allele in patients with HCV RNA ≥2. 0× 106 copy/mL was higher than that in patients with HCV RNA <2. 0 ×106 copy/mL (χ2 =7. 367, P = 0. 007). The frequency of rs3212227 C allele in responders to interferon (IFN) therapy was lower than that in patients with nonresponse to IFN therapy (χ2 =4. 942,P=0. 026). Conclusions The SNP of rs3212227 is correlated with HCV infection. The carriers with C allele may be susceptible to HCV infection, while resistant to IFN therapy.

Objective To discuss the safety of endoscopic sphincterotomy (EST) in treatment of choledocholithiasis in patients over 80 years.Methods From 2005 to 2007,893 patients with choledocholithiasis were divided into group A (n= 148,aged over 80 years) and group B (n=745,aged below 60 years).The clinical data,complications and EST successful rate were retrospectively reviewed between two groups.Results ① The important chronic concomitant diseases were significantly higher in group A than those in group B ( 29.3 % vs 8.1 % ,P＜0.01).② The EST successful rate in group A and B was 95.6% and 96.5%,respectively ( P＞0.05).③ Sixteen patients in group A had complications including 13 caused by EST itself,3 related with EST and one died of aspiration pneumonia.While in group B,41 complications were caused by EST itself and no EST related complications.There was a statistically difference in EST related complications between two groups (P < 0.01 ).In complications caused by EST itself,there was no difference between two groups (P 0.05 ).④ The average hospital stay was ( 7.2 ± 2.2) days in group A and (5.1 ± 1.4) days in group B with no significant difference (P 0.05),Conclusion The EST is safe and effective in treatment of patients over 80 years.

Objective To investigate the clinical features,magnetic resonance imaging (MRI),treatment,and follow-up of patients with glutaric aciduria type Ⅰ (GA-1).Methods Four pediatric patients with GA-1 diagnosed in our hospital were included in this study.They were treated with special diets and carnitine supplements.MRI and tandem mass spectrometry (MS/MS) were performed,and the mental development indices were measured.Results GA-1 was confirmed 2 months,13 months,4 months,and 7 months after birth.Seizure had been observed before the disease diagnosis in three patients and disappeared after treatment.In all four patients,T2-weighted brain MRI showed frontotemporal atrophy or hypoplasia and enlarged subarachnoid space in the sylvian fissures and anterior to the temporal lobes.Diffusion weighted imaging revealed high-density lesions over both the putamen and globus pallidus.The patients were followed up for 4 to 5 years.Plasma amino acids and acylcamitine profile were monitored every 3-5 months.The mean C5DC level and C5DC/C8 were kept the higher limits of the normal ranges,especially in case 3.During the follow-up,the body weight was at-2 SD-0 and the height at-1 SD-0.Intellectual development test showed that case 1 and case 4 had mildly abnormal intelligence,whereas case 2 and case 3 had extremely severe intellectual disability.Gene test confirmed the presence of gene mutations in all four cases,including IVS10-2A ＞ C homozygous mutation in cases 1,3,and 4 and [IVS10-2A ＞ C] + [c.245G ＞c(p.Arg82Pro)] hybrid mutation in case 2.Two female children were smoothly enrolled by local kindergarten,while two male children were unable to walk alone due to delayed motor development and spastic paralysis.Conclusions The phenotype of GA-1 patients is not remarkably correlated with its genotype correlation.Newborn screening is essential for identifying GA-1 patients.

Objective To investigate the safety of endoscopic suhmucosal dissection (ESD) in elderly patients with lesions of gastroesophageal mucosa. Methods Thirty-six elderly patients with flat elevation lesion of gastroesophageal mucosa were studied from July 2007 to May 2008. There were 14 cases with dysplasia, 9 cases with early carcinoma and 13 cases with leiomyoma confirmed by pathologic biopsy and endoscopic ultrasonography. All the patients were treated under consciousness condition, and the focus of lesion were completely resected with improved hook knife, IT knife and electrocoagulation or electro-cutting technique. The wound surface was managed with noradrenaline added in ice physiological saline, argon beam coagulator and metal clips. After operation, they were treated by abrosia, acid suppression and mucosa protection. The conditions of wound healing and residual lesions were reexamined four weeks after operation. Results Among the 36 patients (19 males and 17 females), there were 29 patients(80.6%) with complete focus ablation by ESD and 7 patients (19.4%) with resection by snare. Three cases (8.3%) of perforation occurred during operation and the perforations were treated with metal clips. After inserting stomach tube for fasting and anti-infection treatment for 5-7 days, all the three cases were recovered. One case(2.8%)had hematemesis 2 hours after operation and bleeding was stopped by endoscopic metal clip. Conclusions ESD is a safe and effective therapeutic tool in elderly patients with lesions of gastroesophageal mucosa.

e tissue and myocardium, as well as myocardial uhrastructure were well-improved; the gene expressions of PPAR-α and GLUT4 were raised in APSgroup. APS may be partially effective in treating diabetic cardiomyopathy.

Objective To discuss the individualizing schedule of endovascular treatment for intracranial venous sinus thrombosis based on the clinical feature and the stage of the disease.Methods Forty-three patients diagnosed with intracranial venous sinus thrombosis in Xuanwu Hospital,Capital University of Medical Sciences and in Zhongshan Hospital Xiamen University during period of August 2010 to August 2011 were treated with endovascular therapy designed individually based on the clinical stage of the disease development.Of all 43 cases,22 cases with acute onset (＜ 1 week after the onset) were treated with standard anticoagulant therapy ; 11 cases who failed to respond to anticoagulant therapy and 8 cases with subacute onset (1 week to 1 month) received intravenous thrombolysis and mechanical thrombus maceration;and 13 cases with chronic course (＞ 1 month) were given mechanical thrombus maceration combined with balloon dilation vascular surgery or stent-assisted venous sinus surgery,with taking anticoagulant for 12months.The patients were followed up for 3 to 6 months (mean 4.5 months).Results Their symptoms and signs were all significantly improved,with headache relief in 29 cases(67.4％),vision improvement in 28cases (28/31,90.3％),cerebrospinal fluidpressure decrease to normal level in 32 cases(32/43,74.4％) ;no improvement in 1 case,and a complication of subdural hematoma in 1 case.Three months follow-up of 39 patients,symptoms disappeared,the pressure cerebrospinal fluid in 36 cases returned to normal (94.3％),the papilledema in 37 cases subsided (94.9％).After 6 months,16 patients were followed up with an angiography; 8 of them were found venous sinus clear,5 were found partial recanalization of venous sinus trunk,cortical veins and deep venous was partially compensation,and 3 cases with stent-assisted venous sinus surgery were found the stent not shifted or collapsed,and venous sinuses maintained patency.Conclusions Endovascular treatment for patients with intracranial venous sinus thrombosis should be treated with individually designed therapy based on their clinical features and the stage of the disease.The individualized treatment was effective and safe.

Objective To analyze the quality of life (QOL) of mothers of children with cerebral palsy and it's influencing factors.Methods The QOL of 123 children with cerebral palsy and their mothers was assessed a 36-item short form health survey (SF-36) and basic questionnaires combined with interviews.The factors influencing QOL were analyzed with t-tests and one way analysis of variance,and multiple regression analysis was used to determine the main influencing factors.Results Scores on all of the SF-36 items were much lower for mothers of children with cerebral palsy than for mothers of normal children.Average scores in the domains of emotional health,general health and vitality were the lowest (55.28,60.49 and 65.26 respectively).Correlation analysis showed that general health,physical function and role emotions were positively correlated with the child's age.All domains except pain were negatively correlated with the child's condition.Social functioning was positively correlated with the mother's age.The general health,role emotional,social function,and mental health scores were all negatively correlated with the mother's education level.Univariate analysis showed that the child's age and condition,the mother's education level and occupation,and the father's occupation all significantly predicted the mother's QOL.Multivariate regression analysis confirmed that the child's age and the father's occupation had significant predictive power.Conclusions The QOL of the mother of a child with cerebral palsy is mainly influenced by the child's age and condition,the mother's education level and occupation,and the father's occupation.Comprehensive and effective measures should be taken to improve the QOL of mothers of children with cerebral palsy and to improve the efficacy of rehabilitation for children with cerebral palsy.

In 34 hypothalamic slices of rats, spontaneous discharging of 63 paraventricular neurons was extracellulariy recorded by glass microelectrode. When the slices were perfused with artificial cerebrospinal fluid (ACSF) containing noradrenaline (NA) (10-6 mol/L), firing rates of 20 units significantly increased, those of 8 units decreased or even ceased, and those of 35 units, not affected. When low Ca2+ high Mg2+-ACSF was applied to block synaptic transmission, of 20 units which were excited by NA, 14 units still had excitatory responses and 6 units had no significant response to NA. When synaptic transmission was blocked, of 8 units which were inhibited by NA, 7 units still had inhibitory responses and only one unit had no significant response to NA. The results of this experiment strongly suggest the existence of direct effects of NA on paraventricular neurons.