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BACKGROUND: Preoperative expectations of total knee arthroplasty (TKA) outcomes are important determinants of patient satisfaction. However, expectations of patients in different countries are affected by cultural background. The general goal of this study was to describe Chinese TKA patients' expectations. METHODS: Patients scheduled for TKA were recruited in a quantitative study(n = 198). The Hospital for Special Surgery Total Knee Replacement Expectations Survey Questionnaire was used for survey TKA patients' expectations. Descriptive phenomenological design was used for the qualitative research. Semi-structured interviews were conducted with 15 TKA patients. Colaizzi's method was used for interview data analysis. RESULTS: The mean expectation score of Chinese TKA patients was 89.17 points. The 4 highest score items were walk short distance, remove the need for walker, relieve pain and make knee or leg straight. The 2 lowest score items were employed for monetary reimbursement and sexual activity. Five main themes and 12 sub-themes emerged from the interview data, including multiple factors raised expectations, expectations of physical comfort, expect various activities back to normal, hope for a long joint lifespan, and expect a better mood. CONCLUSIONS: Chinese TKA patients reported a relatively high level of expectations, and differences across cultures result in different expectation points than other national populations, requiring adjustment of items when using assessment tools across cultures. Strategies for expectation management should be further developed. LEVEL OF EVIDENCE: Level IV.
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Artroplastia de Reemplazo de Rodilla , Humanos , Motivación , Pueblos del Este de Asia , Pueblo Asiatico , Articulación de la Rodilla/cirugíaRESUMEN
BACKGROUND: Younger patients who underwent vitrectomy for proliferative diabetic retinopathy (PDR) display more aggressive nature distinguished from the older patients. Preoperative anti-VEGF therapy has been widely used as an adjunct for PDR surgery. However, the effect of anti-VEGF administration in young diabetics has rarely been evaluated in previous studies. The purpose of this study was to evaluate the effects of ranibizumab pretreatment on vitrectomy surgery in young patients with PDR. METHODS: This was a prospective nonrandomized comparative study. Young patients (<40 years old) undergoing diabetic vitrectomy with or without ranibizumab pretreatment (25 eyes in each group) were analyzed in this study. The use of the drug was determined by the patients' own preference. The two surgical groups were matched according to a complexity score. Intravitreal injection of ranibizumab (IVR) was performed 3-5 days prior to the vitrectomy surgery in the IVR group. Intraoperative records including total surgical time, intraoperative bleeding, the use of endodiathermy, the frequency of relaxing retinotomies, the incidence of iatrogenic retinal breaks, and the use of perfluorocarbon liquid (PFCL) and silicone oil tamponade, and postoperative indices regarding recurrent vitreous hemorrhage (VH), neovascular glaucoma (NVG), recurrent retinal detachment, and visual outcome were evaluated between the two groups. All patients were followed up for one year after surgery. RESULTS: In young PDR patients, the severity of intraoperative bleeding was significantly lower in the IVR group than in the control group (P=0.04). The total surgical time was shorter in the IVR group than in the control group. However, the rate of relaxing retinotomy, the incidence of iatrogenic retinal breaks and the use of PFCL and silicone oil tamponade were not affected by IVR pretreatment but affected by the complexity score of the case. Early postvitrectomy hemorrhage occurred less frequently in the IVR group than in the control group (P<0.001), Early visual recovery was better in the IVR group than in the control group (P=0.03). However, there were no significant differences in the development of late recurrent VH, NVG, recurrent retinal detachment, and final visual outcome. CONCLUSIONS: IVR pretreatment is a safe and effective adjunct to vitrectomy in reducing intraoperative and early postvitrectomy bleeding and should be suggested in young PDR patients. However, IVR does not reduce the incidence of intraoperative and late postoperative complications in these patients. The risk of iatrogenic retinal breaks and silicone oil use are closely correlated with the complexity score of the surgical cases.
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Inhibidores de la Angiogénesis/administración & dosificación , Retinopatía Diabética/tratamiento farmacológico , Retinopatía Diabética/cirugía , Ranibizumab/administración & dosificación , Vitrectomía , Adulto , Inhibidores de la Angiogénesis/uso terapéutico , Terapia Combinada , Femenino , Humanos , Inyecciones Intravítreas , Masculino , Estudios Prospectivos , Ranibizumab/uso terapéuticoRESUMEN
Purpose: Pulmonary rehabilitation (PR) is essential to manage patients with COPD. The aim of this study was to investigate the appropriate intensity of PR exercise training for patients with moderate-to-severe COPD. Patients and methods: A prospective multicenter randomized controlled trial was conducted from January 2014 to October 2018. The subjects were randomly assigned to three groups with different intensities of PR, according to their maximum oxygen uptake percentage determined by cardiopulmonary exercise testing. After 20 weeks of exercise training, the effects of low-, moderate-, and high-intensity exercise interventions on patients were compared to determine the most appropriate PR prescription. Results: For patients with moderate COPD, all the measured parameters were significantly improved in the moderate- and high-intensity PR groups (P<0.01), while there was no significant difference in the frequency of acute exacerbations and the mMRC questionnaire after 20 weeks of PR exercise in the low-intensity PR group. For patients with severe COPD, all variables were also improved in the high-intensity PR group (P<0.05), while the mean differences of pre- and post-PR were lower than those in patients with moderate COPD. Moreover, the Hamilton Anxiety Scale and body mass index showed no significant difference in low-intensity PR group (P>0.05). Conclusion: High-intensity PR exercise is helpful for patients with moderate to severe COPD. Moderate COPD patients need to receive intensive PR training; the improvement degrees from PR intervention were higher than those of the severe COPD patients. For patients with severe COPD, high-intensity PR exercise may be more beneficial if patients can tolerate it.
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Terapia por Ejercicio , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Método Simple CiegoRESUMEN
Prostate cancer is one of the most common malignant tumors in the male urinary system as well as the second leading cause of cancer death in men. Prostate specific antigen (PSA) screening is the main method for the early diagnosis of prostate cancer, but has a low specificity for its detection. In recent years, a variety of tumor markers with high sensitivity and specificity have been found. This review focuses on some of the more promising tumor biomarkers such as prostate cancer antigen 3, early prostate cancer antigen, prostate-specific membrane antigen, alpha-methylacyl-CoA racemase, and vascular endothelial growth factor.
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Biomarcadores de Tumor/sangre , Neoplasias de la Próstata/diagnóstico , Antígenos de Neoplasias/sangre , Antígenos de Superficie/sangre , Detección Precoz del Cáncer , Proteínas Ligadas a GPI/sangre , Glutamato Carboxipeptidasa II/sangre , Humanos , Masculino , Proteínas de Neoplasias/sangre , Antígeno Prostático Específico/sangre , Racemasas y Epimerasas/sangre , Sensibilidad y Especificidad , Factor A de Crecimiento Endotelial Vascular/sangreRESUMEN
The physiologically mature tobacco (Nicotiana tabacum) leaves was exposed to different light-emitting diode (LED) lights, i.e. ultraviolet A (UV-A), blue, green, yellow, red, white, to investigate their short-term response. Results showed that: 1) 68 GC/MS-stable metabolites were detected by non-targeted method. In the PLS-DA score plot, tobacco leaf samples showed clear grouping in each light cultivating condition. 61 metabolites were identified in mass spectra library. Besides, 45 metabolites, mainly including organic acids, carbohydrates, TCA cycle intermediate metabolites and amino acids, showed significant differences among the six light treatments. Hierarchical cluster analysis (HCA) and heat map showed that differential metabolites could be divided into five groups, and there were significant differences among the six treatments, especially under red and blue lights. Except for the metabolites of group B, almost all other metabolites contents in tobacco leaves treated with red light were higher than those under blue light. 2) Contents of solanesol, 3 alkaloids and 5 polyphenols were measured with targeted method. 4 alkaloids, including nicotine detected by non-targeted method, showed similar variation among all treatments, of which red and yellow light increased alkaloid accumulation significantly. The kaempferol-3-O-rutinoside and rutin showed similar variation among the six treatments, with the lowest content under blue light and the highest content under yellow light, nevertheless, 3 other polyphenols were differently affected by light qualities. The aolanesol accumulation was significantly repressed by yellow light, but showed highest content under blue light. In conclusion, light quality affected many metabolic pathways significantly in tobacco, such as fatty acid metabolism, glycometabolism, alkaloid metabolism, amino acid metabolism, tricarboxylic acid cycle and shikimate pathway.
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Luz , Metaboloma , Nicotiana/efectos de la radiación , Hojas de la Planta/metabolismo , Cromatografía de Gases y Espectrometría de Masas , Redes y Vías Metabólicas , Hojas de la Planta/efectos de la radiación , Nicotiana/metabolismoRESUMEN
OBJECTIVE: To explore the effect of fixation of Kirschner needle and thread cancellous bone screw through the sinus tarsi interstice for the treatment of calcaneal fractures. METHODS: From January 2009 to December 2012,20 patients with calcaneal fracture were treated by minimally invasive Kirschner wire and threaded cancellous bone screw fixation and bone graft,including 12 males and 8 females with an average age of 39 years old ranging from 21 to 65. Among them, 8 cases were left foot, 12 were right foot. According to Sanders's classification, 8 cases were type II, 10 cases were type III, 2 cases were type IV. RESULTS: All patients were followed up from 6 to 16 months with an average of 12 months. The incision were healed. Böhler angle were increased from preoperative (17.75 +/- 4.22) degrees to postoperative (26.85 +/- 7.37) degrees (t = 4.308, P = 0.000). Gissane angle were reduced from preoperative (137.05 +/- 24.91) degrees to postoperative (113.75 +/- 13.17) degrees (t = 7.083, P = 0.000). At 3 months after operation, the scores of AOFAS were 85.50 +/- 7.99; the results were excellent in 5 feet and good in 11 feet, fair in 3 feet, and poor in 1 foot. CONCLUSION: Minimally invasive fixation of Kirschner needle and thread cancellous bone screw fixation is a simple operation, it can get reliable fixation, easy to remove, low cost, less postoperative complications, and it is a good treatment of calcaneal fracture.
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Tornillos Óseos , Hilos Ortopédicos , Calcáneo/lesiones , Fijación Interna de Fracturas/métodos , Adulto , Anciano , Calcáneo/cirugía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
In this case series of 74 patients with coexisting vitreoretinal injury and severe corneal opacification, after temporary keratoprosthesis (TKP) assisted pars plana vitrectomy (PPV), an allograft corneal transplant was not performed at the same time; instead, the patient's trephined corneal button was sutured back. One year after the surgery, if intraocular pressure of the injured eyes was above 8 mmHg, removing silicone oil was attempted, and penetrating keratoplasty could be performed. Finally, 10 eyes (13.5%) were enucleated due to atrophia bulbi; 46 eyes (62.2%) were silicone-oil sustained; 15 eyes (20.3%) were anatomically restored; and 3 eyes (4.0%) experienced recurrent retinal detachment. These figures only demonstrate a small percentage of the injured eyes in our series, which have PKP indications. It is a practical option to suture back the patient's trephined cornea following a TKP assisted PPV; keratoplasty was reserved for selected cases.
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Xiongdankaiming tablet (XDKMT), a well-known compound in traditional Chinese medicine, is widely used for the treatment of acute iridocyclitis and primary open-angle glaucoma. In this paper, accurate and reliable methods were developed for the identification of 20 constituents using high-performance liquid chromatography with photo-diode array and electron spray ionization-mass spectrometry (HPLC-PDA/ESI-MS(n)), and determination of nine of the constituents (chlorogenic acid, gentiopicroside, isochlorogenic acid B, diosmetin-7-O-ß-d-glucopyranoside, apigenin, diosmetin, tauroursodeoxycholic acid, acacetin, and taurochenodeoxycholic acid) was developed using HPLC with ultraviolet absorption detector and evaporative light scattering detector (HPLC-UV/ELSD) for the first time. The best results were obtained on a Zorbax SB-C18 column with gradient elution using water (0.1% formic acid) (A) and methanol (0.1% formic acid) (B) at a ï¬ow rate of 0.7 ml/min. Tauroursodeoxycholic acid and taurochenodeoxycholic acid, owing to their low UV absorption, were detected by ELSD. The other seven compounds were analyzed by HPLC-UV with variable wavelengths. The calibration curves of all nine constituents showed good linear regression (R(2)>0.9996) within the linearity ranges. The limits of detection and quantification were in the ranges of 0.0460-9.90 µg/ml and 0.115-24.8 µg/ml, respectively. The accuracy, in terms of recovery, varied from 95.3% to 104.9% with relative standard deviations (RSDs) less than 4.4%. Precision (with the intra- and inter-day variations less than 4.4%) was also suitable for its intended use. The developed method was successfully applied for the analysis of major components in XDKMT, which provides an appropriate method for the quality control of XDKMT.
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Cromatografía Líquida de Alta Presión/métodos , Medicamentos Herbarios Chinos/análisis , Espectrometría de Masa por Ionización de Electrospray/métodos , Calibración , Química Farmacéutica/métodos , Cromatografía/métodos , Medicamentos Herbarios Chinos/química , Luz , Medicina Tradicional China , Control de Calidad , Análisis de Regresión , Reproducibilidad de los Resultados , Dispersión de Radiación , Comprimidos , Rayos UltravioletaRESUMEN
OBJECTIVE: To establish a method for the simultaneous determination of 15 pesticides residues in Radix Paeoniae Alba by large volume injection-gas chromatography-mass spectrometry(LVI-GC-MS). METHODS: The pesticides, including organochlorine pesticides, organophosphorus pesticides and pyrethroid insecticides, were analyzed by LVI-GC-MS using DB-5MS capillary column (30 m X 250 µm, 0.25 µm). The column temperature programming: initial temperature 40 degree for 1 min, with the increasing rate of 20 degree/min to 210 degree for 2 min, then with the increasing rate of 5 degree/min to 280 degree for 22 min. The flow of carrier gas was 1.0 ml/min with the injection volume of 15 µl. RESULTS: The calibration curves of the pesticides were linear in the specified concentration ranges with correlation coefficients of 0.9937-0.9995. The average recoveries of the pesticides in Radix Paeoniae Alba spiked at two spiked levels ranged from 60.4 % to 106.8 % (for pendimethalin and 4, 4'-DDE those were 53.1 % and 45.2 %) with relative standard deviation(RSD) of 3.6 % to 18.6 % and the detection limits (S/N=3) were in the range of 0.16 µg/kg to 3.59 µg/kg. CONCLUSION: The established method for determination of multi-pesticide residue in Radix Paeoniae Alba is rapid, convenient and accurate with high sensitivity and low-cost.
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Cromatografía de Gases y Espectrometría de Masas/métodos , Paeonia/química , Residuos de Plaguicidas/análisisRESUMEN
OBJECTIVE: To establish a capillary electrophoresis-mass spectrometry(CE-MS) method for the analysis of nineteen organonitrogen pesticides in Paeoniae Radix Alba. METHODS: CE-MS analysis was performed on a 70 cm X 50 µm fused-silica capillary. The optimal buffer was composed of 1 % formic acid and 15 % methanol(V/V, pH 2.2). The temperature of capillary was controlled at 25 degree. The separation voltage was +20 kV. The optimal MS parameters were as follows: ESI-MS analysis was performed in the positive mode; 90 % methanol containing 0.2 % formic acid with a flow rate of 8 µl·min(-1) was selected as the sheath liquid; the flow rate and temperature of drying gas were 6 L·min(-1) and 250 degree, respectively; The nebulizing gas pressure was set at 5 psig; The optimal values of fragmentor and ESI voltage were 100 V and 5 000 V, respectively. RESULTS: The nineteen pesticides had good linearity over the testing ranges. The average recoveries were in the range of 80.1 %-108.4 % with RSDs less than 20 % (except ethoxyquin and spiroxamine, those of which were 29.2 % and 22.3 % at 0.01 mg.kg(-1) concentration level). The LODs of nineteen pesticides were 0.503 â10.1 µg.kg(-1). CONCLUSION: The method can be used effectively to analyze the nineteen organonitrogen pesticides residue in Paeoniae Radix Alba.
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Electroforesis Capilar/métodos , Espectrometría de Masas/métodos , Paeonia/química , Residuos de Plaguicidas/análisisRESUMEN
OBJECTIVE: To summary the microsurgical techniques for removal of huge tuberculum sellae meningiomas through the bi-subfrontal anterior longitudinal fission approach. METHODS: Eleven patients with huge tuberculum sellae meningiomas underwent microsurgical removal of the meningiomas between January, 2005 and November, 2009. The microsurgical techniques were summarized, and the factors affecting the prognosis were analyzed. RESULTS: Among all the patients, 5 had Simpson grade I meningioma removal and the other patients had Simpson grade II removal. No death occurred in these patients. Nine patients showed vision improvement after the surgery, one had no significant improvement, and the other one experienced worsening of vision. Transient postoperative diabetes insipidus occurred in 5 cases. CONCLUSION: With satisfactory exposure of Dorsum sellae, bottom of the third ventricle and cavernous sinus, the bi-subfrontal anterior longitudinal fission approach is suggested for treatment of tuberculum sellae meningiomas. The key to improve the GTR and reduce the complication lies in the sequence of the operation, namely resection of the tumoral basement before dissection of the potential arachnoidal space and tuberculum.
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Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Microcirugia/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Neoplasias Meníngeas/patología , Meningioma/patología , Persona de Mediana Edad , Silla Turca/patología , Resultado del TratamientoRESUMEN
OBJECTIVE: To investigate the effect of Tuigua manipulation combined with quadriceps exercise for treating degenerative gonarthritis. METHODS: In the study, 48 patients (60 knees) meeting diagnostic criteria of degenerative gonarthritis were randomly divided into two groups: treatment group and control group. The patients in the treatment group were treated with Tuigua manipulation combined with quadriceps exercise; while the patients in the control group were treated with manipulation for osteoarthritis in Tuina Xue. All the patient in the control and treatment group were treated for 3 courses of treatment, and 10 days were one course of treatment. The index such as pain, joint range of motion, function and muscle power were observed and compared before and after treatment. RESULTS: After treatment, in the treatment group, 7 knees were cured, 21 knees got a good result and 2 knees had no effect; while in the control group, the above data were 8, 19, 3 respectively. There was no statistically differences between the therapeutic effects of the two groups. Both methods were effective to improve clinical symptoms of degenerative gonarthritis, and the index such as the pain, joint range of motion, function and muscle power of the patients in two groups were improved after the treatment (P < 0.05). Comparison between the two groups, the improvement of knee function and quadriceps muscle power of patients in treatment group was better than that of control group (P < 0.05); but the improvement of pain and joint range of motion in two groups had no statistically differences (P > 0.05). CONCLUSION: The method of Tuigua manipulation combined with quadriceps exercise is effective to improve clinical signs and symptoms of patients with degenerative gonarthritis, to improve quality of life of patients, slow down degenerative of arthrodial cartilage, prevent the disease aggravating,which is worth spreading.
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Terapia por Ejercicio/métodos , Manipulaciones Musculoesqueléticas/métodos , Osteoartritis de la Rodilla/terapia , Músculo Cuádriceps/fisiopatología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/fisiopatologíaRESUMEN
OBJECTIVE: To evaluate the prognosis of traumatic eyes with no light perception post vitrectomy, and to analyze the risk factors influencing the final results. METHODS: Five hundred and ninety nine mechanically injured eyes in 577 patients undergone vitrectomy were registered from 1999 - 2004. Thirty-eight eyes in this group showed no light perception in initial visual examination. Thirty-two eyes (84.2%) had open-globe injury, the other 6 eyes (15.8%) had closed-globe injury. Excluded the enucleated eyes, the others were followed up for at least 6 months, averaged 7.2 months. All registered data were filled in predesigned forms. Each parameter was evaluated strictly according to the standards of the protocol. The risk factors of poor prognosis and traumatic no light perception were analyzed by logistic regression. RESULTS: Fourteen eyes (36.8%) achieved anatomic and functional success. Three eyes (7.9%) attained anatomic success. Nine eyes (23.7%) were enucleated. Hypotony occurred in 4 eyes. Seven eyes were maintained by silicone oil. Atrophy of eyeball occurred in 1 eye. Twenty-one eyes (55.3%) achieved a final visual acuity of light perception or better, including: 0.2 in 3 eyes, 0.02 in 2 eyes, count finger in 3 eyes, hand move in 3 eyes, light perception in 10 eyes. Eight eyes (21.1%) remained no light perception. The logistic regression analysis identified the significant risk factors predictive of poor prognosis, including traumatic no light perception, presence of a relative afferent pupillary defect (RAPD), massive suprachoroid hemorrhage (MSCH), panretinal detachment with closed-funnel, ciliary body injury, preoperative atrophy of eyeball, prolapse of iris and aniridia, extrusion of crystalline lens, length of scleral wound greater than 10 mm and ruptured injury. These factors were also the risk factors of traumatic no light perception, excluded traumatic no light perception, prolapse of iris and aniridia. More than one risk factor usually co-exists in each eye. CONCLUSIONS: The eyes with traumatic no light perception have poor prognosis. However, 45% of them can achieve functional and anatomic success undergone vitrectomy. Eyes with no light perception are related to the combination of various risk factors. MSCH, severe retinal injury and extensive ciliary body injury are the main risk factors for poor prognosis.
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Lesiones Oculares/fisiopatología , Lesiones Oculares/cirugía , Vitrectomía , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Células Fotorreceptoras de Vertebrados , Pronóstico , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To observe the histopathological changes of a novel small-caliber vascular graft after implantation in canine theca interna under scanning electron microscope. METHOD: A 3 cm segment of the vascular graft (diameter of 4 mm) was implanted in an end-to-end fashion to bridge the severed carotid artery in 19 healthy dogs. Color Doppler sonography was performed 2 weeks after the operation to observe the patency rate of artificial blood vessel. At 1, 8, 12 and 24 week postimplantation, the arteries (4, 4, 6 and 5, respectively) were collected for optical and scanning electron microscopies after angiography to observe the patency of the arteries. RESULTS: Of the total of 19 arteries, occlusion occurred in 1 at 12 weeks and 1 at 24 weeks. Optical and electron microscopies showed that 1 week after implantation, slight fibroplasias and formation of red thrombus could be seen at the vascular anastomosis without endothelial cell lining. At 8 weeks, the host tissue grew into the lumen of the graft through the pores to form uniform neointima consisting of plenty of collagen fibers, but still without endothelial cells. At 12 weeks, discontinuous endothelial cells were seen to grow on the surface of the neointima. In the middle segment of the vascular graft, immature endothelial cells were found to grow in clusters. The structure of the neointima was loose in comparison with that at the anastomosis, with occasional inflammation cells. Twenty-four weeks after grafting, endothelial cells grew over the entire inner wall of the patent graft, and the surface of the neointima at the anastomosis was lined with continuous endothelial cells. CONCLUSION: The vascular graft can be useful for reconstruction of canine carotid artery defect and achieves good endothelialization 24 weeks after implantation.
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Implantación de Prótesis Vascular/métodos , Prótesis Vascular , Arterias Carótidas/cirugía , Modelos Animales , Animales , Arterias Carótidas/diagnóstico por imagen , Arterias Carótidas/fisiología , Colágeno/metabolismo , Perros , Células Endoteliales/citología , Células Endoteliales/metabolismo , Células Endoteliales/ultraestructura , Microscopía Electrónica de Rastreo , Factores de Tiempo , Túnica Íntima/citología , Túnica Íntima/metabolismo , Túnica Íntima/ultraestructura , Ultrasonografía Doppler en Color , Grado de Desobstrucción VascularRESUMEN
OBJECTIVE: To evaluate the risk factors and study the methods of prevention and treatment for the ruptures of aneurysms in keyhole minimally invasive approaches. METHODS: From 1999 to 2005, 115 cases of intracranial aneurysms were divided into 2 classes according to the risk factors of aneurysm rupture. Forty-three cases of lower risk underwent microsurgical procedures as keyhole approaches, including pterional approach in 20 cases, supraorbital approach in 18 cases, interhemispheric approach in 5 cases. Seventy-two cases, rest of microsurgical procedures, were performed as conventional craniotomy, including pterional approach in 31 cases, supraorbital approach in 11 cases, interhemispheric approach in 7 cases, pterional-supraorbital in 10 cases, pterional-interhemispheric in 6 cases, supraorbital-interhemispheric in 4 cases, pterional-supraorbital-interhemispheric in 3 cases. RESULTS: Six aneurysms leaked and 3 ruptured (rupture rate 7.0%) treated with keyhole approaches during operations. No one died by keyhole approaches. Eighteen aneurysms leaked and 9 ruptured (rupture rate 12.5%) treated with conventional approaches during operations. Two patients died by conventional approaches. CONCLUSIONS: Keyhole approaches as a time-saving, trauma-reducing procedure could improve the postoperative outcomes, but these approaches still exist probability of aneurysm rupture. It is possible that keyhole-bone flap becomes a limitation to deal with huge or ruptured aneurysms. And it is important to make a specially preventive strategy for aneurysm rupture.
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Aneurisma Roto/prevención & control , Aneurisma Intracraneal/cirugía , Complicaciones Intraoperatorias/prevención & control , Procedimientos Quirúrgicos Mínimamente Invasivos , Procedimientos Neuroquirúrgicos/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
BACKGROUND: Isoniazid (INH) is widely used in the therapy of tuberculosis. Poor metabolizer (PM) of the NAT2 is an important reason of inter-individual difference of the plasma INH concentration. We studied the relationship between NAT2 genotype and INH and its metabolite acetylisoniazid (AcINH) concentration in Chinese people. METHOD: Forty-six tuberculosis patients were enrolled in the study. Each patient took 300 mg INH daily for at least 7 days. Two hours after the INH was given, the vein blood was drawn. NAT2 genotypes of patients were detected by a reverse dot blot (RDB) method. The plasma concentration of INH and AcINH was determined by a precolumn derivation HPLC method. RESULTS: In 46 patients, homozygous mutant (m/m), heterozygous mutant (m/wt) and homozygous wild-type (wt/wt) subjects were 7, 22 and 17, respectively. Plasma concentration of INH and AcINH were 12.74+/-10.51 and 12.49+/-9.61 micromol/l, respectively. There was no statistical difference among 3 genotypes. The ratios of AcINH and INH (R(A/I)) of 3 genotypes were 0.67+/-0.34, 0.88+/-0.40 and 1.69+/-0.66, respectively. The R(A/I) of m/m and m/wt group were significantly lower than wt/wt group (P<0.01). CONCLUSION: The results suggest that various NAT2 genotypes in Chinese tuberculosis patients have great impact on the metabolism capacity of NAT2. This finding maybe valuable in the rational use of relevant drugs.
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Antituberculosos/sangre , Arilamina N-Acetiltransferasa/genética , Isoniazida/análogos & derivados , Isoniazida/sangre , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/genética , Antituberculosos/uso terapéutico , China , Cromatografía Líquida de Alta Presión , Genotipo , Heterocigoto , Homocigoto , Humanos , Isoniazida/uso terapéuticoRESUMEN
OBJECTIVE: To evaluate the effects of TIMP-2 local gene transfer on atherosclerotic plaque. METHODS: Atherosclerosis models were induced by denuding femoral artery endothelium plus high lipid diet in rabbits. TIMP-2 gene was transferred locally by balloons eluted with pcDNA3-TIMP-2. RT-PCR and Western blot were performed to verify exogenous genes transfer. MMPs activity in atherosclerotic plaque was evaluated by zymography. HE and VG staining and automatic image analysis system were used for pathological analysis of atherosclerotic femoral arteries. The lumen area of the vessel and the collagen contents in the atherosclerotic plaque were measured. RESULTS: The expression of TIMP-2 gene in pcDNA3-TIMP-2 transferred group was significantly higher than control-vector transferred group at the end of week 2 after operation and reached the peak at the end of week 4. Comparing with the control group, the expression of TIMP-2 protein in treated group was also higher at the end of week 2, 4, and 8 after operation. Correspondingly, the MMP-2 and MMP-9 activities were lower in treated group. The thickness of fibrous cap of atherosclerotic plaque and the amount of collagen of the lesion were increased significantly in treated group compared with the control group, but there were no significant differences in vessel lumen area. CONCLUSION: TIMP-2 gene transfer locally in atherosclerotic plaque could inhibit the activities of MMP-2 and MMP-9 in the lesion, increase the thickness of fibrous cap and the amount of collagen of the lesion, but may have no effect on the degree of the stenosis.
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Aterosclerosis/enzimología , Transferencia de Gen Horizontal , Inhibidores de la Metaloproteinasa de la Matriz , Inhibidor Tisular de Metaloproteinasa-2/genética , Animales , Aterosclerosis/patología , Western Blotting , Colágeno/análisis , ARN Mensajero/análisis , Conejos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Inhibidor Tisular de Metaloproteinasa-2/fisiologíaRESUMEN
The CN radical was produced by Penning AC discharge of the mixture of trace acetonitrile (36 Pa) and helium (660 Pa) and the ro-vibrational spectra were measured by optical heterodyne magnetic rotation enhanced concentration modulation spectroscopy in the range of 16 850-17 480 cm(-1). 138 lines and 118 lines were assigned to the (6, 1) and (7, 2) bands in red system A 2IIi-X 2sigma+ of CN respectively, while others were due to (8, 3) band in CN red system and C2 Swan band system. More accurate molecular constants of A 2IIi (v = 6, 7) state and perturbation parameters zeta and eta between A and X states were derived based on nonlinear least-square fitting, individually, by diagonalizing the effective Hamiltonian matrix involving the perturbation elements of two electronical states and the standard deviation of fitting was less than the experimental uncertainty 0.007 cm(-1), which implied the accuracy of our results.
Asunto(s)
Cianuros/química , Radicales Libres/química , Análisis Espectral/métodos , Acetonitrilos/química , Algoritmos , Isótopos de Carbono , Helio/química , Modelos Químicos , Análisis Espectral/instrumentación , VibraciónRESUMEN
In Singapore, there has been a growing public interest in traditional Chinese medicine (TCM), which plays an important role in the healthcare system. With effect from 1 September 1999, the control on Chinese Proprietary Medicines (CPM) was implemented in three phases over a span of 3 years. Under the CPM regulatory framework, CPM importers, wholesalers, manufacturers and re-packers must be licensed and CPM products assessed and listed by the health authority before they are allowed for sale. Product assessment is based on the criteria of safety and quality which include limits of toxic heavy metals and microbial contents. During the 3-year CPM listing exercise, irregularities were detected, including intrinsic toxicity, adulteration, substitution, contamination, misidentification, non-traditional and/or inappropriate usage, incorrect preparation, inappropriate labelling, exaggerated claims and/or advertising. The full implementation of CPM control by September 2001 saw the listing of 7943 CPM products and brought about an improvement in the quality and safety of CPM in Singapore as well as the removal of sub-standard, fake/imitation and adulterated products. The standards of practices by local CPM dealers have also been raised. These improvements have, in turn, increased the level of public confidence in CPM products in Singapore.
Asunto(s)
Regulación Gubernamental , Legislación de Medicamentos , Medicina Tradicional China , Etiquetado de Medicamentos , Control de Calidad , Seguridad , SingapurRESUMEN
OBJECTIVE: To summarize the clinical results of the artificial iris diaphragm (AID implantation for eyes with silicone oil longstanding tamponade. METHODS: In this study the operation indications results and complications of 11 consecutive cases of artificial iris diaphragm implantation for eyes with silicone oil longstanding tamponade were studied. RESULTS: In all of the 11 primary ocular disorder cases, 7 cases (7/11) were serious ocular trauma, 2(2/11)cases were diabetic retinopathy with traction retinal detachment, 1 case (1/11) was recurrent retinal detachment with complicated PVR, and 1 case (1/11) was Coats disease; The silicone oil was retained completely behind the surface of artificial iris diaphragm in 7(7/11) of all the 11 cases in which no visual acuity was affected The complications were low intraocular pressure IOP and heavy fibrosis on the surface of artificial iris diaphragm. CONCLUSION: Open type artificial iris diaphragm implantation in eyes with longstanding silicone oil tamponade can effectively prevent the silicone oil from cotacting the cornea causing complication by spontaneously blocking and rescuing anterior chamber fluid circulation.