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Objective:To compare the diagnostic value of three quantitative evaluation methods based on three-dimensional rapid fluid attenuation inversion recovery sequence (3D-FLAIR) vein-enhanced labyrinth images in endolymphatic hydrops.Methods:From October 2017 to April 2019, a retrospective study was conducted on 86 patients with unilateral otogenic vertigo who were admitted to Beijing Tongren Hospital, Capital Medical University. MRI was performed 8 h after the single-dose Gd-DTPA intravenously injection in all patients. Three evaluation methods were used to calculate the ratio of the endolymphatic area to the total lymphatic area, the ratio of the saccule to utricle area, and the ratio of the endolymphatic volume to the total lymphatic volume, respectively. The paired t test was used to compare the three ratios between the affected and healthy ears. With clinical diagnosis as the gold standard, the receiver operating characteristic (ROC) curve analysis was used to analyze the efficacy of three methods in diagnosing endolymphatic hydrops. Results:Totally 65 cases were finally diagnosed endolymphatic hydrops clinically. There were statistically significant differences of all the 3 ratios between the affected and healthy ears ( t=9.93, 7.22, 8.20, all P<0.001). The ROC curve showed that the area under the curve (AUC) of endolymph/total lymph area ratio, saccule/utricle area ratio, endolymph/total lymph volume ratio for diagnosis of endolymphatic hydrops were 0.882, 0.768, 0.884 (all P<0.001). And there were no significant differences between each paired AUCs (all P>0.05). Conclusions:All three methods of endolymph/total lymph area ratio, saccule/utricle area ratio, endolymph/total lymph volume ratio can quantitatively evaluate endolymphatic hydrops. The endolymphatic/total lymphatic area ratio method is still the most convenient method at present.
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BACKGROUND: Compound cotton rose hibiscus leaf ointment is developed from the continuous optimization of the preparation process of traditional famous prescription "Xiaozhong San". Xiaozhong San has been used in Ruijin Hospital Affiliated to School of Medicine of Shanghai Jiaotong University for over 40 years and has achieved good clinical outcomes. OBJECTIVE: To verify the clinical efficacy and safety of compound cotton rose hibiscus leaf ointment, laying a foundation for its popularization and application in the treatment of acute soft tissue injury. METHODS: 112 cases of acute soft tissue injury were divided into trial group (n=55) and control group (n=57) according to the random number table method. The experimental group selected the compound cotton rose hibiscus leaf ointment, and the control group selected the compound Zijing ointment. RESULTS AND CONCLUSION: (1) There were no statistical differences in the primary outcomes, such as pain, tenderness, swelling, dysfunction and in the secondary outcomes, such as ecchymosis, insomnia, dry mouth, constipation, tongue coating and pulse condition, between the two groups before treatment, at 3 and 7 days of treatment and after treatment termination (P> 0.05). (2) The two groups achieved obvious clinical outcomes in the treatment of acute soft tissue injury, but there was no difference in the clinical efficacy between the two groups (P> 0.05). (3) The two groups had no obvious abnormalities in the routine of hematuria and stool and the function of the liver and kidney. (4) There were only five cases of mild skin allergy, including two cases in the trial group and three cases in the control group. To conclude, the compound cotton rose hibiscus leaf ointment has good clinical efficacy and safety, which is worthy of clinical application.
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Objective To systematically evaluate the efficacy and safety of Wiltse approach and conven-tional posterior midline approach for single thoracolumbar fracture. Methods Databases including Embase, PubMed,cnki,WanFang Data were searched to collect the related literatures for single thoracolumbar fracture treated with surgery of Wiltse approach and conventional posterior midline approach. The data were collected and evaluated by different reviewers independently and the Meta analysis was conducted by using the RevMan 5.3. Results A total of 6 literatures involving 351 patients were included. The results of Meta-analysis showed that there were significant differences in surgical duration,intraoperative bleeding,postoperative discharge volume, and visual analog score(VAS)(P < 0.000 01). There was no significant difference between the Cobb angle(P =0.69)and the fanterior edge convex height(P=0.46).Conclusions Wiltse approach is superior to conventional posterior midline approach for single thoracolumbar fracture with shorter surgical duration,less intraoperative blood loss,less postoperative discharge and lower incidence of postoperative backache. It reduces spine malformation, maintains height of the fanterior edge convex.Wiltse approach is a safe and feasible surgical technique for treating single thoracolumbar fracture.
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Objective To investigate the correlation between procalcitonin (PCT) and infarct related artery (IRA) spontaneous recanalization (SR) in patients with ST-segment elevation myocardial infarction (STEMI), and to investigate the value of PCT in predicting SR. Methods A retrospective study was conducted. A total of 263 STEMI patients who received emergency coronary angiography from January 2013 to April 2016 in cardiology department of Gansu Provincial Hospital were retrospectively included. Depending on the thrombolysis in myocardial infarction trial (TIMI) grade, the patients were divided into two groups, SR group (TIMI 2-3 grade) and non-SR group (NSR group, TIMI 0-1 grade). The baseline characteristics, serum PCT, high sensitivity C-reactive protein (hs-CRP) and biochemical makers before primary percutaneous coronary intervention (PCI) were compared. According to the value of PCT, the patients were divided into four quartile groups. SR rate of every groups were compared. Multiple logistic regression analysis was used to determine the independent predictor of SR. Receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of PCT for SR. Results In 263 STEMI patients, SR occurred in 77 patients and SR rate was 29.3%. There were no statistical differences in gender, age, body mass index (BMI), past medical history and IRA between the two groups, indicating that the baseline characteristics were matched. Compared with NSR group, utilization rate of the statins were significantly higher (35.1% vs. 22.6%, P 0.110 μg/L. SR rate were 48.5% (32/66), 29.9% (20/67), 26.9% (18/67) and 11.1% (7/63), respectively. SR rate of Quartile 1 was significantly higher than the other three groups (all P < 0.05). It was shown by multiple logistic regression analysis that PCT [odds ratio (OR) = 0.432, 95% confidence interval (95%CI) = 0.108-0.863, P = 0.016], hs-CRP (OR = 0.708, 95%CI = 0.516-0.905, P = 0.037) were independent predictors for SR. The area under the ROC curve (AUC) of PCT for predicting SR was greater than that of hs-CRP [0.784 (95%CI = 0.721-0.847) vs. 0.686 (95%CI = 0.619-0.753), P < 0.05]. When the cut-off value of PCT was 0.067 μg/L, the sensitivity was 81.6%, and the specificity was 66.7%. Conclusion PCT was independent predictor of SR, which has a power value in predicting IRA recanalization in patients with STEMI.
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BACKGROUND:At present, the clinical application of intramedul ary nail in the treatment of tibial shaft fractures has achieved good results. However reamed and unreamed intramedul ary nail in repair of tibial fractures in adults remains controversial. OBJECTIVE:To evaluate clinical efficacy and safety of reamed versus unreamed intramedul ary nailing for the treatment of tibial fractures in adults. METHODS:The literature related to application of reamed or unreamed intramedul ary nailing for tibial fractures published from 1980 to 2015 were searched from Springer, PubMed, and Wanfang database. Related Chinese and English journals of orthopedics were hand-searched. Al randomized control ed trials were col ected. RevMan5.0 provided by Cochrane was used to analyze the data. RESULTS AND CONCLUSION:Seven randomized control ed trials were included according to inclusion criteria, including 1 331 patients. There were 682 cases in the reamed intramedul ary nailing group and 649 cases in the unreamed intramedul ary nailing group. Meta-analysis results showed that compared with the reamed intramedul ary nailing group, implant failure rate was significantly higher in the unreamed intramedul ary nailing group [MD=0.37, 95%CI (0.24, 0.57), P<0.000 01], and nonunion rate was significantly higher [MD=0.54, 95%CI (0.31, 0.93), P=0.03]. There was no significant difference in the incidence of compartment syndrome, the rate of malunion and postoperative infection rate. Results suggested that no difference in the incidence of compartment syndrome, the rate of malunion and postoperative infection rate was found in reamed and unreamed intramedul ary nailing in the repair of adult tibial fractures. Reamed intramedul ary nailing has advantages of low implant failure rate and nonunion rate.
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Objective: To observe blood levels of cystetine C (Cys C) and superoxide dismutase (SOD) in patients with obstructive sleep apnea syndromes (OSAS) related hypertension (HP). Methods: A total of 102 HP patients received polysomgography (PSG) in our hospital from 2013-01 to 2013-12 were studied. According to apnea hypopnea index (AHI), the patients were divided into 2 groups: OSAS with HP (OH) group, n=55 patients with AHI≥5 and HP group,n=47 patients with AHI0.05. Conclusion: Blood levels of Cys C in OH and HP groups were higher than Control group, Cys C in OH group was higher than HP group; SOD levels in OH and HP groups were lower than Control group, SOD in OH group was lower than HP group. The relationships between Cys C, SOD and OH severity were unclear.
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Objective: To explore the effect of persistent atrial ifbrillation (AF) on circadian rhythm of blood pressure (BP) in patients with essential hypertension (EH). Methods: A total of 173 EH patients treated in Gansu Provincial Hospital from 2013-02 to 2014-01were studied. The patients were divided into 2 groups: EH group,n=88 and Persistent AF combining EH group,n=85. The baseline information was studied and the risk factors of persistent AF combining EH were investigated by multivariate logistic regression analysis. Results: Compared with EH group, the Persistent AF combining EH group showed decreased average daytime DBP, minimum daytime SBP, minimum daytime DBP and the average 24-hour DBP, while increased maximum nighttime SBP and the percentage of reverse dipper in DBP, allP0.05. Multivariate logistic regression analysis indicated that the maximum nighttime SBP was obviously related to persistent AF combining EH (OR=1.038, 95 CI 1.014-1.062,P=0.001). Conclusion: Persistent AF may incur daytime BP dropping, such change was not obviously observed for nighttime BP in EH patients.
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Objective To investigate the effect of bone marrow stem cells (BMSCs) transplantation combined with body weight supported treadmill training on neural functional recovery of rats with spinal cord injury.Methods T11 complete spinal cord injury (SCI) was introduced into 40 Sprague-Dawley male rats using an improved simple device,imitating the Allen method.The rats were randomly divided into a stem cell transplantation group,a body weight support treadmill training group,a combined treatment group and a control group,each of 10 assigned according to a random number table.One week after the SCI operation,stem cell transplantation was performed on the rats in the stem cell transplantation group and the combined treatment group.One day before their transplantation,the third passage BMSCs were labeled with 5-ethynyl-2'-deoxyuridine (Edu).The rats in body weight support treadmill training group and combined treatment group were received body weight support treadmill training,while the other two groups were not given any training.At the 1 st,2nd,3rd,4th and 5th week after SCI modeling,Basso-Beattie-Bresnahan (BBB) movement function score was used to evaluate the motor function recovery of all rats.At the 5 th week after SCI,immunohistochemical staining and immunofluorescence staining was applied to detect neural specific markers including the neuron specific enolase (NSE),microtubule associated protein (MAP-1 β) and vimentin (VIM).The survival and differentiation of the transplanted cells,as well as the nerve fiber recovery in the lesion were also observed.Results The average BBB score of the combined treatment group was (6.60 ± 0.97) at the 2nd week after SCI operation,significantly higher than the other 3 groups,while that of the stem cell transplantation group and the body weight support treadmill training group was (5.00 ± 0.67) and (4.80 ± 0.63) respectively,both higher than that of the control group but without significant differences (P ＞ 0.05).In the third week after modeling,however,the value of the stem cell transplantation group rose to (8.00 ± 0.67),significantly higher than that of the body weight support treadmill training group (6.80 ± 0.79).The immuohistochemical staining showed that a variable degree of neural specific markers (NSE,MAP-1 β,VIM) positive cells were observed in the SCI tissues of all groups,with those in the combined treatment group significantly higher than the other 3 groups.The immunofluorescence also found significantly higher fluorescence expression of neural specific protein markers including NSE,MAP-1 βand VIM in the combined treatment group than the rest group,with obvious proliferation and differentiation of nerve fibers.Conclusions Stem cell transplantation combined with partial body weight supported treadmill training can effectively promote the recovery of neural function of rats with spinal cord injury,and the effect is better than solely stem cell transplantation or the weight loss training.
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BACKGROUND:At present, it remains controversial whether open reduction plate fixation is needed for distal radius fracture in the elderly to restore anatomic reduction of imaging. OBJECTIVE:To systematical y evaluate the curative effects of operative and nonoperative treatments for distal radius fractures in the elderly. METHODS:We retrieved PubMed, Springer and Wanfang database using computer. Relevant English and Chinese journals of orthopedics were retrieved by hand. Al literatures on curative effects of operative and nonoperative treatments for distal radius fractures in the elderly were col ected. RevMan 5.0 software provided by Cochrane was used to statistical y analyze the data. RESULTS AND CONCLUSION:Six literatures were included, including two of randomized control ed study and four of retrospective cohort study. Meta-analysis results displayed that there were no significant differences in both groups in range of motion of wrist joint extension [mean difference (MD)=-0.87, 95%confidence interval (CI) (-3.31, 1.58), P=0.49], range of motion of wrist joint flexion [MD=-2.79, 95%CI(-6.47, 0.88), P=0.14], range of motion of wrist pronation [MD=-0.08, 95%CI(-1.49, 1.64), P=0.92], range of motion of supination [MD=-0.7, 95%CI(-3.52, 2.12), P=0.63] and the occurrence of complication [MD=1.35, 95%CI(0.71, 2.56), P=0.36]. The length of radius in the surgery group was similar to that of normal [MD=2.46, 95%CI(1.78, 3.15), P<0.01]. Ulnar inclination [MD=3.73, 95%CI(2.97, 4.48), P<0.000 01] and palmar tilt angle [MD=6.81, 95%CI(3.72, 9.90), P<0. 000 1] in the surgery group were close to that of normal. There are no significant differences in extension, flexion, pronation and supination activities of wrist and posttreatment complication between two groups. Operative treatment result is superior to that of nonoperative treatment in anatomic reduction.
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Objective To evaluate the effect of open reduction and multi-dimensional several pin fixation of Gartland type Ⅲ supracondylar fractures with late callus formation in children.Methods The study involved 37 children of Gartland type m supracondylar fractures with late callus formation undergone posteromedial elbow incision,open reduction via bilateral triceps sparing approach,several K-wire internal fixation and early functional rehabilitation from May 2009 to May 2011.There were 23 males and 14 females at 3-13 years of age (mean,7 years).Postoperative results were evaluated according to Flynn standard.Mean 9.5 months of follow-up was made.Results The results were excellent in 28 cases,good in five,fair in two and poor in two.No serious complications occurred after operation.Conclusion Open reduction and multi-dimensional several K-wire fixation is an effective treatment for Gartland type Ⅲ supracondylar fractures with late callus formation in children and hence provides a choice for clinical use.
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Embryonic stem (ES) cells hold great promise in regenerative medicine and it is an urgent task to understand the underlying molecular mechanisms that control ES cell fate choice between self-renewal and differentiation. In mouse ES cells, extrinsic leukemia inhibitory factor (LIF) and bone morphogenetic protein (BMP) signaling pathways play pivotal roles in maintaining the self-renewal status under serum and feeder free culture conditions. Intrinsic extracellular-signal regulated kinase (ERK) activity is also important in determining mouse ES cell fate-low ERK activity keeps mouse ES cell self-renewal while high ERK activity drives differentiation. We recently found that while LIF signaling augments ERK activity, BMP signaling inhibits ERK activity in mouse ES cells via direct upregulation of an ERK phosphatase-dual-specificity phosphatase 9. The cooperative effects of LIF and BMP signaling keep appropriate ERK activity and maintain mouse ES cell self-renewal (Li et al., 2012). These findings shed light on how extrinsic signals converge to intrinsic signaling molecules to regulate cell fate determination. This perspective summarizes our recent new findings and discusses the current unsolved questions and future directions.
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Animais , Humanos , Camundongos , Proteínas Morfogenéticas Ósseas , Metabolismo , Células-Tronco Embrionárias , Metabolismo , MAP Quinases Reguladas por Sinal Extracelular , Metabolismo , Transdução de SinaisRESUMO
Objective To study the effect and mechanism of the neurological function recovery in rats with spinal cord injury (SCI) rats after the transplantation of neural stem cells which are directly differentiated from bone marrow mesenchymal stem cells (BMSC), and to investigate the suitable engraftment time.Methods The BMSC at 3rd passage were differentiated into neural stem cells (NSC), and immunofluorescence staining was used to identify the NSC. The oriented-induced cells were labeled with Brdu 3 days before they were transplanted, and they were slowly injected into the injured site of the SCI rats. The SCI rats were randomly divided into group Ⅰ (transplantation at first week postinjury), group Ⅱ (transplantation at 2nd week postinjury) and control group (the operation was the same as group Ⅰ, but the cell suspension was replaced by the equal volume of normal saline). The BBB scores after transplantation were recorded. The distribution and differentiation of transplanted cells were observed by using immunofluorescence staining with antibodies against Brdu combined with Nestion and Brdu combined with NF200. NF200 immunofluorescence staining was used to show the regeneration of nerve fibers. The pathological changes of the injured site were observed by HE staining.Results The nestin expression was positive after the BMSC were differentiated for 3 days, and if the induced spherical cells were cultured continuously, the different levels of NF200 and GFAP were found. BBB scores in group Ⅰ and group Ⅱ were significantly higher than in control group (P<0.05), especially in group Ⅰ. The immunofluorescence showed that a large number of Brdu and Nestin double-positive cells and some Brdu and NF200 double-positive cells filled the injured site and linked the two sides of the injured area in group Ⅰ and group Ⅱ, and the lesion area of the spinal cord was reduced as compared with control group (P<0.05). More importantly, further reduction in lesion area and improvement in neurological function were observed in group Ⅰ.Conclusion The BMSC can be differentiated into NSC. The transplantation of the NSC could effectively promote the nerve function recovery after SCI, and the effect of transplantation at first week postinjury was better than at 2nd week postinjury.
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Objective To investigate the association of HLA-A and -B alleles with syphilis in Shandong Han population. Methods The allele frequencies of HLA-A and -B were detected in 205 patients with syphilis and 5844 normal human controls by PCR-sequence specific oligonucleotide probe (PCR-SSOP)method. Results The patients with syphilis showed a higher frequency of HLA-A*02, B*15, B*40 alleles(all P＜0.01, Pc＜0.05) and a lower frequency of HLA-A*26 allele (P= 0.003, Pc = 0.039) than the normal human controls did. There was an increased frequency of HLA-B*15 and B*40 alleles in patients with symptomatic syphilis (both P＜0.01, Pc＜0.05), as well as an elevated frequency of HLA-A*02, 11, 29, B*15 and 40 alleles (all P＜0.01, Pc＜0.05) and a decreased frequency of HLA-A*30 and 33 in patients with asymptomatic syphilis(P=0.002, 0.026, Pc=0.001, 0.013 respectively), compared with the normal human controls. The frequency of HLA-A*30 allele was significantly higher in patients with symptomatic syphilis than in those with asymptomatic syphilis (P = 0.001, Pc = 0.013). Conclusions There seems to be an association between HLA-A*02, B* 15 and B*40 alleles and syphilis, between HLA-A*30 allele and symptomic syphilis, and between HLA-A*02, 11 and 29 alleles and asymptom1atic syphilis, in Shandong Han population.
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Sixty patients who underwent brain and neck CT angiograpby (CTA) were randomly divided into two groups: conventional protocol group and optimizing protocol group with 30 in each. The images were evaluated by two radiologists independently. The images of optimizing group avoided the artifact disturbance of the brachiocephalic vein effectively and greatly improved the imaging quality of arteria carotis communis and arteria vertebralis initial segment. Compared with the conventional group the differences were statistically significuat(P <0.05). The optimization of 64-MDCT brain and neck CTA is feasible and effective.
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BACKGROUND: Although partner notification (PN) has long been considered as an important component in sexually transmitted disease (STD) control programs and has been implemented in both developed and developing world, little information is known about the acceptability and efficacy of the strategy in China. GOAL: The goal of this study was to assess the acceptability and outcome of self-referral for male patients with urethral discharge and to identify the characteristics associated with successful outcome based on a specialized STD clinic. METHODS: From November 2001 to November 2002, 730 patients with confirmed urethral discharge were selected and asked by STD clinicians to bring their sexual contacts to treatment in a specialized STD clinic. The demographic and sexual characteristics of returned and unreturned index patients were analyzed. Univariate and multivariate analyses were applied to identify the characteristics associated with the outcome of self-referral. RESULTS: Of 723 eligible index patients, 294 (40.7%) who returned for follow up identified 534 sexual partners and 429 (59.3%) who did not return for follow up identified 759 sexual partners. Of the total named 1293 sexual partners, 301 (23.3%) were notified by index male patients and 265 (20.5%) presented at the clinic. Of the 265 partners tested, 165 (62.3%) were infected with gonorrhea, chlamydia, or both; of them, 78 (47.3%) were asymptomatic. When the partnerships were married and steady, the informed rate was higher than that when the partnership was casual. For commercial sexual partnerships, only 1.8% of the partners were informed. In multivariate analysis, a prior STD history and condom use during the last sexual contact were associated with successful outcome of notification. CONCLUSION: Patient referral was accepted both by STD clinic attendees and STD clinicians. The results of the study show that use of self-referral for partners of men with urethral discharge in a Chinese STD clinic was, with minimal effort, moderately successful. Further efforts to improve case-finding outcomes are warranted.
