Objective : To explore the effects of mouth floor approach intubation in the treatment of jaw fracture combined with skull base injury. Methods : From Jan. 2014 to Oct. 2015, 7 cases of jaw fracture combined with skull base injury were selected from Medical center of Stomatology, Foshan Hospital of Traditional Chinese Medicine (FSTCM). All cases were treated with mouth floor approach intubation, because they were not suitable to be given the oral or nasal intubation anesthesia. Results : All the patients healed well after operation, and there was no tube accident or other complications. Conclusions For patients of jaw fracture combined with skull base injury, the mouth floor approach intubation could be recommended as a supplementary choice for traditional intubation methods.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications

OBJECTIVETo assess the diagnostic value of double balloon endoscopy (DBE) for obscure gastrointestinal bleeding (OGIB) METHODS: The data of 103 OGIB patients who underwent DBE from January 2007 to September 2010 in the First Affiliated Hospital, Zhejiang University School of Medicine were retrospectively analyzed.

RESULTSDBE was successfully performed in all 103 patients without complications. Of 103 patients, 66(64.1 %) had positive DBE findings and 28 had surgery procedures(27.2 %). Ninety-four patients finally acquired positive diagnosis, including small intestine tumor(31.1 %), angiodysplasia(22.3 %), exulceratio simplex(9.7 %), Crohn's disease(6.8 %), diverticulum(4.9 %), abdominal purpure(4.9 %), etc. Lesions occurred more frequently in proximal small intestine than in distal small intestine (56.3 % Compared with 30.1 %, P<0.001).

CONCLUSIONDBE is a safe, effective and reliable procedure for the diagnosis of OGIB.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Capsule Endoscopy ; methods ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

BACKGROUNDThe protective effects of magnesium sulfate against ischemia-reperfusion injury of the small intestine in Sprague-Dawley (SD) rats have been confirmed in our previous research. However, its exact mechanism is unclear. This study was to evaluate the role of PI3K/Akt signal pathway in the protective effect of magnesium sulfate against ischemia-reperfusion injury of the small intestine in SD rats.

METHODSRat model of intestinal ischemia-reperfusion injury was used. The SD rats were divided into four groups randomly: sham operation group, ischemia-reperfusion group, magnesium sulfate group and magnesium sulfate plus LY294002 (an inhibitor of PI3K) group. The pathological changes of intestinal mucosa were examined; the activity of diamine oxidase (DAO) in plasma, the plasma contents of malondialdehyde (MDA), and apoptosis rate of the intestinal mucosal cells were determined and compared. The expression of p-Akt was detected by Western blotting.

RESULTSThere were more evident pathological changes of the intestinal mucosa (higher Chiu's score, P < 0.05), enhanced DAO activity (P < 0.05), elevated contents of MDA (P < 0.05), higher apoptosis rate (P < 0.05), and lower level of p-Akt (P < 0.05) in the ischemia-reperfusion group compared with the sham operation group. There were less evident pathological changes of the intestinal mucosa (lower Chiu's score, P < 0.05), lower DAO activity (P < 0.05), lower contents of MDA (P < 0.05), and lower apoptosis rate (P < 0.05), but higher level of p-Akt (P < 0.05) in the magnesium sulfate group compared with the ischemia-reperfusion group. There were more evident pathological changes of the intestinal mucosa (higher Chiu's score, P < 0.05), higher contents of MDA (P < 0.05), higher DAO activity (P < 0.05) and higher apoptosis rate (P < 0.05), and lower level of p-Akt (P < 0.05) in the magnesium sulfate plus LY294002 group compared with the magnesium sulfate group.

CONCLUSIONSActivation of PI3K/Akt signal pathway results in the reduction of cell apoptosis, which likely accounts for the protective effect of magnesium sulfate against intestinal ischemia-reperfusion injury.

Amine Oxidase (Copper-Containing) ; metabolism ; Animals ; Apoptosis ; drug effects ; Blotting, Western ; Disease Models, Animal ; Intestinal Mucosa ; cytology ; drug effects ; Intestine, Small ; drug effects ; Magnesium Sulfate ; therapeutic use ; Malondialdehyde ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Signal Transduction ; drug effects

OBJECTIVEThe aim of this study was to evaluate the correlation of protein expressions of CXC chemokine receptor 4 (CXCR4), vascular endothelial growth factor-C (VEGF-C) and cytokeratin 19 (CK-19) with lymph node metastasis (LNM) in patients with hepatocellular carcinoma (HCC), and their survival.

METHODSThe expressions of CXCR4, VEGF-C and CK-19 in HCC patients with (n = 123) or without (n = 145) LNM were determined using tissue microarray and immunohistochemical staining. The relationship between clinicopathological features and CXCR4, VEGF-C and CK-19 were analyzed. Evaluation of immunostaining was performed semiquantitatively by visual assessment.

RESULTSThe UICC T stage, and expressions of nuclear CXCR4, VEGF-C and CK-19 were independent risk factors for LNM. Nuclear CXCR4, VEGF-C and CK-19 expression were predictive factors for LNM in HCC patients. In patients with LNM, the median survival time was 15.1 months for patients with high nuclear CXCR4 expression and 24.5 months for those with low nuclear CXCR4 expression. The median survival time was 15.1 months for patients with high tumor VEGF-C expression and 31.1 months for those with low tumor VEGF-C expression. The median survival time was 12.0 months for patients with positive CK-19 expression and 19.2 months for patients with negative CK-19 expression. Patients with high nuclear CXCR4, VEGF-C or CK-19 expression had significantly poorer prognosis than those with low expression (all P < 0.05). PVT, UICC T stage and expressions of nuclear CXCR4, VEGF-C, and CK-19 were independent prognostic factors.

CONCLUSIONIncreased protein expressions of nuclear CXCR4, VEGF-C, and CK-19 are independent risk factors for developing lymph node metastasis, and they are significantly correlated with LNM and poor outcome in HCC patients.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Nucleus ; metabolism ; Female ; Follow-Up Studies ; Humans ; Keratin-19 ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Receptors, CXCR4 ; metabolism ; Risk Factors ; Survival Rate ; Vascular Endothelial Growth Factor C ; metabolism

Background and Objective:The mechanism of tumor tissues selectively uptaking the photosensitizer in photodynamic therapy(PDT)is still unclear.This study was to investigate the affinity of tumor cells to the photosensitizer photofrin-Ⅱ. Methods: Ultraviolet spectrophotometer was applied to measure the absorption spectra of various cell culture media.The fluorescence spectrum of photofrin-Ⅱ was determined by spectrofluorometer.The absorption and eIimination condition of photofrin-Ⅱ were detected in immortalized human esophageal epithelial cell line SHEE and its malignant transformation cell line SHEEC.Results:The maximum excitation wavelength of fluorescence for photofrin-Ⅱ was(395.0±0.5) nm, and the maximum emission wavelength of that was (634.1±0.5) nm.The laser at the wavelength of 630 nm used in this experiment could permeate various types of cell culture media.There was no significant difference in the absorption and elimination of photofrin-Ⅱ between SHEE and SHEEC at the same concentration and time.The absorption of photofrin-Ⅱ in SHEE and SHEEC increased with the increase in photofrin-Ⅱ concentration and duration. and reached the platform at the concentration of 30 μg/mL and a time point of 150 min.respectively.The photofrin-Ⅱ contents of SHEE and SHEEC showed a slight change after 15-30 min, and diminished rapidly after 30 min.Conclusion:High photosensitizer concentration in tumor tissues may be not correlated with the affinity of tumor cells.

OBJECTIVESTo investigate the possibilities of an association between the degrees of HBV suppression with nucleoside treatments at week 24 and week 52 in hepatitis B patients and to find a useful predictor for treatment efficacy.

METHODSIn this phase III, double-blind, multicenter trial, we compared the efficacy of telbivudine treatment with lamivudine treatment in 332 Chinese compensated chronic hepatitis B patients. The patients were randomly assigned to a daily 600 mg telbivudine treatment group or daily 100 mg lamivudine group for 24 weeks. They were then categorized into 4 groups according to their serum HBV DNA levels (copies/ml) at week 24: a PCR-undetectable group (< 300 copies/ml); a QL- < 10(3) copies/ml group; a 10(3)-<10(4) copies/ml group; and a > or = 10(4) copies/ml group. The treatments were continued as they previously had been for another 28 weeks and the patients serum HBV DNA levels were examined again.

RESULTSAt week 52, mean reductions of serum HBV DNA were significantly greater in the telbivudine-treated patients than in the lamivudine-treated group (6.2 log10 vs 5.4 log10, t = 3.6, P < 0.01). Viral resistance was twice as common in lamivudine-treated patients compared to those receiving telbivudine. Telbivudine was well-tolerated with an adverse event profile similar to that of lamivudine. The lower the HBV DNA level achieved at week 24, the higher HBV DNA non-detectable by PCR. ALT normalization and HBeAg seroconversion achieved at week 52, and viral resistance at week 48 decreased parallel to the degree of HBV DNA inhibition.

CONCLUSIONHBV DNA PCR-undetectable at week 24 in nucleoside-treated hepatitis B patients suggests a better efficacy at week 52 and lower viral resistance at week 48. The degree of suppression of HBV at week 24 may be used as a predictor of 1-year outcome.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Double-Blind Method ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Pyrimidinones ; therapeutic use ; Thymidine ; analogs & derivatives ; Treatment Outcome ; Young Adult

OBJECTIVETo develop an HPLC method to determine Puerarin, Daidzin and Daidzein in Pueraria lobata.

METHODThe separation was performed in a SYMMETRY C18 column with a mobile phase of methanol-1% HAC solution (gradient elution), the The detection wavelength being 250 nm.

RESULTThe average recovery was respectively 101.7%, 100.7% and 101.7% (n = 3), RSD 0.43%, 0.82% and 1.50% (n = 3) for Puerarin, Daidzin and Daidzein.

CONCLUSIONThis method is suitable for the determination of Puerarin, Daidzin and Daidzein in Pueraria lobata and its preparation.

China ; Chromatography, High Pressure Liquid ; methods ; Ecosystem ; Isoflavones ; analysis ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Pueraria ; chemistry ; Quality Control

Objective To achieve computer visualization of the first Chinese visible male and female Methods After acquisition of the dataset of the first Chinese visible male and female (2 518 cross sections were obtained from the visible male, the complete data files take up 90 468 GBs; while 3 640 cross sections from the female, the complete data files take up 131 04 GBs ), we processed 2 D images in an SGI Workstation and on P4 computer respectively Then, image registration was performed through reserved scaling point Reconstruction was achieved by two approaches: volume rendering reconstruction and surface rendering reconstruction Results We visualized the whole body and special parts of Chinese visible male and female on an SGI Workstation and a personal computer respectively Furthermore, by optimizing 3 D reconstruction and data processing technique, interactive 3 D visualization of the dataset was achieved Conclusions ①The dataset of the first Chinese visible male and female proves to be eligible for 3 D visualization research ②The platform setup of interactive 3 D visualization of Chinese visible male and female dataset provides foundation for digital human anatomy and virtual surgery ③The models of human organs and parts built through data segmentation, classification, registration and drawing lay basis for rendering complex structures of the whole human body delicately

Objective To establish more detailed dataset of Chinese visible human male. Methods After undergoing macroscopical, CT and MRI examinations to exclude organic lesion, a young aged, middle sized male cadaver was selected as the subject. First, morphological measurement and vascular perfusion were performed. Second, after embedding with 5% gelatin, the cadaver was put in ice house and frozen to -30 ℃ for 1 week. Third, TK 6350 numerical control milling machine (milling accuracy of 0.001 mm) was used to shave off slices of the body layer by layer from head to foot at -25 ℃ in low temperature laboratory. Fourth, the successive cross sections were photographed with high resolution digital camera and scanned into an animation computer. Thus, data acquisition from cadaver model was completed to obtain structural dataset of the human body. Results The selected sample was a 21 year old, 1 820 mm in height, 66 kg in weight male died due to non organic disease. CT with 1.0 mm slice thickness for the head and neck and 2.0 mm for the rest of the body was performed. MRI with 1.5 mm slice thickness for the head and neck and 3.0 mm for the rest of the body was also performed. A total of 18 398 serial cross sections with the thickness of 0.1 mm of each section were obtained. The digital photographs were sampled at a resolution of 10 989 056 (4 064?2 704) pixels. The data file of each section occupies 62.9 MB. The complete data files occupy 1 157.23 GB. The research results are issued simultaneously on the Internet (http://www.chinese visiblehuman.Conclusion ① Review of the related literatures reveals that the thinnest thickness of the reported cross section of the visible human dataset is 0.2 mm(the thickness of the sections of the skull base of the first case of Chinese visible human reported by our research group is 0.1 mm.), and the slices consist of several thousands of serial cross sections with several millions of pixels. The data files occupy several tens of GB or more than 100 GB. However, the thickness of the cross sections of the whole body of the dataset achieved in our research is 0.1 mm. The total slices consist of 18 398 serial cross sections with the photographic resolution of 11 million pixels and the total data file reaches 1 157.23 GB. The three indexes mentioned above are elevated by 1 log unit. ② We have solved the key technical problems in data acquisition of visible human such as super thin serial cross sectioning, enormous quantity of data storing and display of tiny blood vessels.