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Objective:To investigate the effect of acupoint stimulation assisted anesthesia on the agitation during recovery and the levels of serum opioids (Opiorphin) and amyloid A (SAA) in elderly patients after hip fracture surgery.Methods:Eighty-six older patients who underwent hip fracture surgery in Shaoxing Second Hospital from February 2020 to September 2021 were randomly divided into the routine group and the research group, each with 43 patients. They were given acupoint sham stimulation and acupoint stimulation respectively, and the general indexes of the two groups, recovery quality, cognitive function and changes in serum Opiorphin and SAA levels were compared.Results:There were no differences in operation time, anesthesia time, recovery time and intraoperative blood transfusion between the two groups ( P>0.05). The dosage of remifentanil in the research group was significantly lower than that in the routine group: (270.64 ± 17.62) μg vs. (291.82 ± 23.34) μg, P<0.05. The incidence of agitation during the recovery period in the research group was significantly lower than that in the routine group: 13.95% (6/43) vs. 48.84% (21/43), P<0.05. The mini-mental state examination (MMSE) scores in the research group at 12, 24 and 48 h after operation were significantly higher than those in the routine group: (22.80 ± 2.04) scores vs. (19.31 ± 3.61) scores, (24.92 ± 2.44) scores vs. (21.49 ± 3.58) scores, (26.73 ± 2.57) scores vs. (24.23 ± 3.95) scores, there were statistical differences ( P<0.05). The serum Opiorphin level at 24 h after operation in the research group was higher than that in the routine group: (32.74 ± 8.57) mg/L vs. (25.40 ± 6.36) mg/L; and the SAA level was lower than that in the routine group: (157.36 ± 10.24) mg/L vs. (204.37 ± 15.56) mg/L, there were statistical differences ( P<0.05). Conclusions:Acupoint stimulation adjuvant anesthesia can reduce the occurrence of agitation during the recovery period of elderly patients with hip fracture, reduce the dosage of anesthetics, reduce postoperative cognitive impairment, regulate serum Opiorphin and SAA levels, and help early postoperative recovery.
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Objective To investigate the clinical efficacy of spinal endoscopic surgery for lumbar posterior ring apophysis separation (PRAS) via percutaneous transforaminal approach.Methods A retrospective case series study was conducted to analyze the clinical data of 32 patients with lumbar PRAS admitted to the First Affiliated Hospital of Fujian Medical University from September 2016 to March 2018.There were 20 males and 12 females,aged 20-47 years [(33.7 ± 6.6)years].All patients had singlesegment lesions.The injured segments were at L3/4 in seven patients,L4/5 in 14 patients,L5/S1 in 11 patients.All patients were treated with spinal endoscopic surgery via porcutaneous transforaminal approach.The incision length,operation time,intraoperative blood loss,intraoperative fluoroscopy times of C-arm X-ray machine and operational complications were recorded.At 24 hours,3 months and 12 months after operation,the efficacy was evaluated by visual analogue score (VAS),Oswestry dysfunction index (ODI) and modified MacNab criteria.Results All patients were followed up for 12-30 months,with an average of 15.5 months.The incision length was 7-9.5 mm [(8.0 ±t 0.9) mm],the average operation time was 60-155 minutes [(80.5 ± 13.2) minutes],the average intraoperative blood loss was 5-25 ml [(10.6 ± 5.7) ml] and the average number of fluoroscopy was 5-25 times [(9.4 ±3.4) times].The patients were permitted to move wearing hard waist 8-12 hours after operation and returned to normal work and life 6 weeks after operation.Postoperative dysesthesia was noted in one patient,who recovered after neurotrophy and physiotherapy after one week.There were no complications such as open surgery conversion,intervertebral space infection,nerve root injury and dural sac laceration.The VAS and ODI at 24 hours,3 months and 12 months after operation [low back pain VAS:(3.4 ± 1.5) point,(1.8 ± 1.1) points,(1.7 ± 0.9) points;leg pain VAS:(1.8 ± 1.0) points,(1.6 ±0.8)points,(1.4±0.6)points;ODI:(26.8 ±9.7)％,(13.9 ±4.3)％,(12.8 ±2.8)％] weresignificantly improved compared with those before operation [back pain VAS:(7.3 ± 2.1) points,leg pain VAS:(7.9 ± 2.7) points;ODI:(56.2 ± 15.6)％] (P ＜ 0.05).According to the modified MacNab criteria,the results were excellent in 25 patients,good in five patients,and fair in two patients,with the excellent and good rate of 94％.Conclusion Spinal endoscopic surgery for lumbar PRAS via percutaneous transforaminal approach is an effective method with advantages of small incision,less complications,effective pain relief and fast functional recovery.
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Objective@#To investigate the clinical efficacy of spinal endoscopic surgery for lumbar posterior ring apophysis separation (PRAS) via percutaneous transforaminal approach.@*Methods@#A retrospective case series study was conducted to analyze the clinical data of 32 patients with lumbar PRAS admitted to the First Affiliated Hospital of Fujian Medical University from September 2016 to March 2018. There were 20 males and 12 females, aged 20-47 years [(33.7 ± 6.6)years]. All patients had single-segment lesions. The injured segments were at L3/4 in seven patients, L4/5 in 14 patients, L5/S1 in 11 patients. All patients were treated with spinal endoscopic surgery via percutaneous transforaminal approach. The incision length, operation time, intraoperative blood loss, intraoperative fluoroscopy times of C-arm X-ray machine and operational complications were recorded. At 24 hours, 3 months and 12 months after operation, the efficacy was evaluated by visual analogue score (VAS), Oswestry dysfunction index (ODI) and modified MacNab criteria.@*Results@#All patients were followed up for 12-30 months, with an average of 15.5 months. The incision length was 7-9.5 mm [(8.0±0.9)mm], the average operation time was 60-155 minutes [(80.5±13.2) minutes], the average intraoperative blood loss was 5-25 ml [(10.6±5.7)ml] and the average number of fluoroscopy was 5-25 times [(9.4±3.4) times]. The patients were permitted to move wearing hard waist 8-12 hours after operation and returned to normal work and life 6 weeks after operation. Postoperative dysesthesia was noted in one patient, who recovered after neurotrophy and physiotherapy after one week. There were no complications such as open surgery conversion, intervertebral space infection, nerve root injury and dural sac laceration. The VAS and ODI at 24 hours, 3 months and 12 months after operation [low back pain VAS: (3.4±1.5)point, (1.8±1.1)points, (1.7±0.9)points; leg pain VAS: (1.8±1.0)points, (1.6±0.8)points, (1.4±0.6)points; ODI: (26.8±9.7)%, (13.9±4.3)%, (12.8±2.8)%] were significantly improved compared with those before operation [ back pain VAS: (7.3±2.1)points, leg pain VAS: (7.9±2.7)points; ODI: (56.2±15.6)%] (P<0.05). According to the modified MacNab criteria, the results were excellent in 25 patients, good in five patients, and fair in two patients, with the excellent and good rate of 94%.@*Conclusion@#Spinal endoscopic surgery for lumbar PRAS via percutaneous transforaminal approach is an effective method with advantages of small incision, less complications, effective pain relief and fast functional recovery.
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INTRODUCTION@#Paraquat (PQ) intoxication is frequently associated with a high mortality rate. No specific treatment has been shown to reduce mortality in victims within the first 72 hours. We investigated the protective effects of rapamycin (Rapa) against PQ-induced toxicity in a zebrafish model.@*METHODS@#To determine the maximum nonlethal concentration (MNLC) and lethal concentration 50 (LC50) of Rapa, zebrafish were treated at 2-5 days post fertilisation (dpf) and their mortality was recorded every 24 hours. At 5 dpf, the zebrafish were treated with PQ 100 µg/mL or PQ+Rapa (MNLC, 1/3 MNLC or 1/9 MNLC) for 72 hours, and the rate of survival was recorded every 24 hours. Reverse transcription-polymerase chain reaction was used to test the signalling pathway of mTOR (mammalian target of rapamycin).@*RESULTS@#MNLC and LC50 of Rapa were determined to be 6.7 µg/mL and 28.9 µg/mL, respectively. At 48 hours, the PQ+Rapa groups had much lower mortality than the PQ group. The rates of survival of the PQ+Rapa groups were 43.33% (MNLC), 53.89% (1/3 MNLC) and 44.45% (1/9 MLNC), as compared to 19.45% in the PQ group, with the 1/3 MNLC group showing the highest rate of survival (p < 0.001). atg1 was slightly activated in the PQ group. In the PQ+Rapa groups, the expression of atg1 was markedly increased, suggesting strengthening of the autophagy process.@*CONCLUSION@#Rapa can increase the rate of survival of PQ-intoxicated zebrafish by inhibiting mTOR complex 1 and activating autophagy. Rapa could be an alternative first-line drug in the treatment of PQ poisoning.
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The process of axonal injury after ischemic stroke can be roughly divided into three stages. Each stage has its different temporal and spatial pattern, as well as unique molecular cascade reactions. The process of axonal injury is also related to ischemic stroke subtype, and the treatment must be adjusted accordingly. Axon-glial intercellular neurotransmitter-energy metabolism coupling disorder and Ca2 + overload-mediated apoptosis-like degeneration are the main mechanisms of early axonal injury after stroke. Axonal regeneration and remyelination of damaged axons after stroke play an important role for the recovery of neurological function. Elucidating the axonal injury and repair mechanism after stroke can provide a new strategy for stroke treatment.
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Objective To investigate the relationship between the marrow edema and general clinical index,quadriceps muscle area,and the meniscus grade of knee osteoarthritis(OA).Methods 72 patients were collected with knee OA in our hospital, underwent X-ray and routine MRI examination of knee, and the same X-ray and MRI were reviewed at 12 months later in different time point.The K-L grading, bone marrow edema score, meniscal grading and VAS score of each knee joint were evaluated.The t-test and Rank-sum test were used to compare the two groups of general data, Spearman was used to perform bivariate correlation analysis.Results The age and VAS score of bone marrow edema group at the initial follow-up were significantly lower than those without edema group(P<0.05),the degree of marrow edema was moderately correlated with age and VAS score, and was not significantly correlated with other indexes.12 months later, BMI and the area of quadriceps femoris in the group with marrow edema were different from those in the group without bone marrow edema(P<0.05), the degree of marrow edema was moderately correlated with age, quadriceps area and VAS.Conclusion The range of marrow edema was related to age, quadriceps area, BMI index and VAS score in MRI.The MRI measurement could reflect the progression of knee OA more than that of X-ray.It also revealed some factors related to the progression of knee OA.
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@#Objective To observe the effect of Arm Spasticity Inhibitor worn in rehabilitation training on patients with upper extremities spasticity and shoulder subluxation after stroke. Methods 80 stroke patients with flexor spasm in upper extremities complicated with subluxation of shoulder were divided into treatment group and control group equally. Both groups accepted routine medicine and rehabilitation, and the treatment group wore the Arm Spasticity Inhibitor developed ourselves during the rehabilitation training. Their acromio-humeral interval (AHI) was measured with the X- ray; and they were assessed with modified Ashworth Scale (MAS), range of motion of shoulder (ROM) and elbow before and 2 months after treatment. Results It improved more in the AHI, score of MAS and ROM in the treatment group than in the control group after treatment (P<0.001). Conclusion Wearing Arm Spasticity Inhibitor during rehabilitation training may release the spasticity of upper extremities and shoulder subluxation, and improve shoulder function in patients after stroke.
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Objective To observe the effect of Arm Spasticity Inhibitor worn in rehabilitation training on patients with upper extremities spasticity and shoulder subluxation after stroke. Methods 80 stroke patients with flexor spasm in upper extremities complicated with sublux-ation of shoulder were divided into treatment group and control group equally. Both groups accepted routine medicine and rehabilitation, and the treatment group wore the Arm Spasticity Inhibitor developed ourselves during the rehabilitation training. Their acromio-humeral in-terval (AHI) was measured with the X-ray; and they were assessed with modified Ashworth Scale (MAS), range of motion of shoulder (ROM) and elbow before and 2 months after treatment. Results It improved more in the AHI, score of MAS and ROM in the treatment group than in the control group after treatment (P<0.001). Conclusion Wearing Arm Spasticity Inhibitor during rehabilitation training may release the spasticity of upper extremities and shoulder subluxation, and improve shoulder function in patients after stroke.
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Objective To evaluate the effects of psychological nursing process on the quality of life and its related factors in maintenance hemodialysis patients.Methods Ninety maintenance hemodialysis patients from September 2013 to September 2014 were selected as research object,and they were divided into control group 45 cases and observation group 45 cases by random digits table method.The patients in control group received routine psychological intervention,while the patients in observation group received psychological intervention with nursing process.The two groups were evaluated and compared with Short Form 36 Health Survey Questionnaire score (SF-36), Self-Efficacy for Managing Chronic Disease(SEMCD) and Perceived Social Support Scale(PSSS) before and after the intervention at 6th and 12th month.The score changes of each scale were analyzed by repeated-measures analysis of variance and multivariate analysis of variance.Results The number of patients that had completed the whole intervention process was 42 in control group and 44 in observation group.The SF-36 scores of two groups were all increased gradually with the extension of intervention time (time effect, all P＜0.01), but compared with control group, observation group had a trend towards better SF-36 score except for the dimension of physical functioning(interactive effect, all P＜0.01).In all dimensions of SF-36, the scores of physical role,general health,vitality and social function in observation group as a whole were higher than those in control group (group effect, all P＜0.05).Similarly, the SEMCD and PSSS scores of two groups were all increased gradually with the extension of intervention time (time effect, all P＜0.01), but the increasing trend of observation group was more obvious than control group (interactive effect, all P＜0.01).Conclusions The application of psychological nursing process can effectively improve the life quality of maintenance hemodialysis patients, and have a satisfied long-term effect,which may be related to the continuous improvement of psychological nursing process on the self-efficacy and perceived social support of the patients.
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Objective To evaluate outcomes of modified transforaminal lumbar interbody fusion (TLIF) assisted by the minimally invasive expandable access system and spinal channel endoscope for acute and chronic lumbar intervertebral disc injury.Methods From March 2013 to November 2014, 45 patients with lumbar intervertebral disc injury were managed with minimally invasive (Group A) or open TLIF (Group B).Location for disc injury was at L3/4 in 5 patients, L4/5 in 28 patients and L5-S1 in 12 patients.Group A composing 12 males and 10 females showed age of (53.70 ±3.59) years (range, 43 to 67 years).Group B composing 14 males and 9 females showed age of (54.80 ± 4.37) years (range, 42 to 68 years).Between-group comparison was conducted with respect to operation time, blood loss, postoperative drainage loss, ambulation time and postoperative complications.Clinical outcomes were evaluated using the visual analogue scale (VAS), Oswestry dysfunction index (ODI), and bone fusion rate.Results Except for the comparable operation time, group A was associated with better results in the blood loss [(152.1 ± 15.5) ml vs (409.9 ± 28.3) ml], drainage volume [(106.1 ± 14.3)mlvs (223.0 ± 19.4)ml], ambulation time[(4.5 ±1.1)d vs (8.9 ±1.4)d] and 1-week postoperative VAS [(3.0±0.7) points vs (4.7 ±0.4) points] (P ＜0.05).At the final follow-up, VAS and ODI of both groups were significantly improved compared to the preoperative levels (P ＜ 0.05), but the differences between groups were insignificant (P ＞0.05).Bone fusion rate in Group A was 95％ (21/22) versus 96％ (22/23) in Group B 6-month postoperatively (P ＞ 0.05).No nerve root injury, intervertebral space infection or other complications occurred.Conclusion Modified TLIF assisted by the minimally invasive expandable access system offers the benefits of less trauma, less bleeding and a quicker recovery for acute and chronic lumbar intervertebral disc injury and has similar long-term clinical outcomes with open TLIF.
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ObjectiveTo explore the treatment options for fresh Grauer type Ⅱ odontoid fractures and discuss corresponding clinical outcome.Methods The study involved 40 patients with fresh odontoid fractures including seven with type Ⅱ A fractures, 18 with type Ⅱ B and 15 with type ⅡC according to Grauer classification.There were five patients with incomplete cervical cord injuries.Type Ⅱ A fractures were treated by traction of occipital-jaw band or skull for 1-2 weeks and then fixed with head-neck-chest plaster or brace.Type Ⅱ B fractures were treated with anterior odontoid screw system fixation.Fifteen patients with type Ⅱ C fractures and three patients with type Ⅱ B fractures combined with severe fracture displacement were managed with posterior atlantoaxial pedicle screw fixation.Results All the patients were followed up for 6-24 months.Seven patients with type Ⅱ A fractures showed union after fixation with head-neck-chest plaster or brace for 3-6 months.Fifteen patients treated with odontoid screw fixation had good positions of screws, with no injury to the spinal cord, of which 14 patients obtained bone union, with union rate of 93.3％.Eighteen patients (including 15 patients with type Ⅱ C fractures and three with type Ⅱ B fractures combined with severe displacement) managed with atlantoaxial pedicle screw system showed no injury to the vertebral artery and spinal cord.Solid bone fusion was achieved.in 31 patients after 3 to 6 months.The X-ray and SCT scans verified proper fixation of the screws, with no deformation, loosening or breakage of the screws.Five patients with incomplete cervical cord injuries obtained neural function recovery at various degrees after surgery.ConclusionsConservative treatment cau be alternative to type ⅡA fractures.Anterior odontoid hollow screw fixation is better for type ⅡB fractures (non-displaced or reducible) and has advantages of minor trauma, fast postoperative recovery and high union rate.However, posterior atlantoaxial pedicle screw system fixation and fusion is suitable to type Ⅱ C and ⅡB fractures with severe displacement and has the advantages of stable three-dimension fixation, direct screw placement, intraoperative reduction, short-segment fixation and high fusion rate.
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Objective To explore the technique and clinical outcome of the atlantoaxial pedicle screw system in the treatment of the unstable atlantoaxial dislocation post traction.Methods The study involved 32 patients with atlantoaxial dislocation(type T2 of TOI classification)admitted from March 2005 to September 2009.There were 17 patients with fresh odontoid fracture and two with old odontoid fracture,five with traumatic disruption of the transverse atlantal ligament and eight with congenital odontoid dysplasia.JOA scores of neurological function before operation was at a range of 5-13(average 8.38).The average of space available for the cord(SAC)was 9.15 mm.Before the atlantoaxial pedicle screw system was carried out,the skull traction was performed in all the patients preoperatively.Results A total of 128 pedicle screws were inserted safely,with mean operation time and perioperative blood loss for 1.5 hours and 300 ml,respectively.No injury to the vertebral artery or spinal cord was observed.All the patients were followed up for 12-24 months,which showed that JOA scores one year after operation was increased to 10-17(average 14.56),with the improvement rate of 71.70%,and that the SAC was average 14.86 mm.The X-ray and SCT scans verified the proper position of the screws,with no internal fixation failure or atlantoaxial redislocation.After 3-6 months,all the patients except for one patient achieved a solid bone fusion.One year after operation,the one patient with no bone graft fusion was removed of the internal fixation system and obtained satisfactory restoration of the rotational function.Conclusions Atlantoaxial pedicle screw system is an effective method for the treatment of the unstable atlantoaxial dislocation post traction,for it has the advantages of stable three-dimension fixation,direct screw placement,intraoperative reduction and high fusion rate.
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Objective To investigate the effects of Glibenclamide on reduction of secondary damage after acute spinal cord injury in rats.Methods Ninety rats were randomly divided into control group (laminectomy alone),spinal cord injury group(injury group),and treatment group(treated with Glibenclamide after spinal cord injury),with 30 rats in each group.The pathological morphology changes of injured spinal cord were observed by HE staining and electron microscope.The expressions of sulfonylurea receptor 1 (SUR1)were detected by immunohistochemical method at 45 min,6 h,24 h,3 d and 7 d after spinal cord injury,and IPP 6.0 software were used for quantitative analysis.The function recoveries of the hind limbs of rats were evaluated by BBB score.The blood sugar level was detected quantitatively.Results HE staining showed that tissue bleeding and microglia proliferation getting severe with time after spinal cord injury.Compared to the injury group,tissue bleeding,microglia proliferation and inflammatory cell invasion was less severe in treatment group.Showed by electron microscope,inflammatory cell invasion,myelin sheath layer structure damage and mitochondrial swelling were significantly reduced after Glibenclamide treatment.Detected by immunohistochemical staining,the expressions of SUR1 at all time points after injury,except for 45 min that there were no SUR1 expressions in all groups,were much weaker in the treatment group than in the injury group.The SUR1 expression reached the peak at 24 h after injury in injury group,and decreased gradually with time.Significant differences were found in the SUR1 expression among three groups by oneway ANOVE.The BBB scores of treatment group were significant higher than that of injury group.The blood sugar slightly decreased in the treatment group,while no significant difference was found among three groups.Conclusion Glibenclamide can significant reduced the secondary damage after acute spinal cord injury.The protection of Glibenclamide after spinal cord injury may relate to its suppression of SUR1.
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BACKGROUND:Gene therapy is the direction of spinal cord injury(SCI) therapy,the key of which is construction of targeting gene and vector. OBJECTIVE:To construct the recombinant adenovirus vector carrying human brain-derived neurotrophic factor(hBDNF) marked enhanced green fluorescent protein(EGFP). DESIGN,TIME AND SETTING:A single sample observation was completed in the First Affiliated Hospital of Fujian Medical University from September 2007 to June 2008. MATERIALS:Competent E. coli DH-5? was obtained from the American Stratagene Company. Plasmid pDC316-hBDNF,pDC316-mCMV-EGFP,pBHGlox_E1,3Cre and package system AdMax and 293 package cell strain were purchased from the Canadian Mixcrobix-Biosystems Company. METHODS:The hBDNF gene was constructed by PCR with plasmid pDC316-BDNF as template. With enzyme digestion,the hBDNF gene was inserted into the vector pDC316-mCMV-EGFP and the shuttle plasmid pDC316-hBDNF-mCMV-EGFP was constructed,which was cotransfected with the adenovirus skeleton plasmid pBHGlox_E1,3Cre into 293 cells to obtain the produced replication defective recombinant adenovirus vector Ad-hBDNF-EGFP. The recombinant adenovirus was propagated by repeat infection of 293 cells and purified by ion exchange method,then the virus particles were counted and the purity and titer were determined. MAIN OUTCOME MEASURES:①PCR identification of plasmid pDC316-hBDNF. ②Construction and identification of the shuttle plasmid pDC316-hBDNF-mCMV-EGFP. ③Packing,amplification and purification of recombinant adenovirus vector Ad-hBDNF-EGFP. ④PCR identification of the recombinant adenovirus. ⑤Titer of recombinant adenovirus. RESULTS:PCR amplification,restriction analysis and sequencing identified that both recombinant shuttle plasmid pDC316-hBDNF-mCMV-EGFP and recombinant adenovirus vector Ad-hBDNF-EGFP were correctly constructed. After amplification and purification,the virus particle count,A260/A280 and titer of recombinant adenovirus were 2.4?1011 VP/mL,2.0 and 0.8?1010 CCID50/mL,respectively. CONCLUSION:Recombinant adenovirus vector Ad-hBDNF-EGFP is successfully constructed,which laid a foundation for further study regarding gene function and therapy.
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BACKGROUND: There is no effective measure to repair the large scope bone defect in clinic till now.OBJECTIVE: To explore the feasibility on repairing bone defect of rabbit radius by autologous bone marrow stem cells.DESIGN: Self-controlled groping study focused on experimental animals.SETTING: Department of orthopaedics of a university hogpital.MATERIALS: The study was completed in the Experimental Animal Centre of Fujian Medical Science Institute. Twelve healthy New Zealand rabbits with half sex each were selected with body mass of 3.1 to 3.4 kg.METHODS: The marrow of rabbit ilium was collected and separated, cultured in vitro to prolifeiate bone marrow stromal stem cells and then mixed with biological materials to transplant the distal bone defect area of rabbit radius. X-ray, gross samples and histological section were used to observe the repairing effects.ture of bone marrow stromal stem cellsRESULTS: X-ray showed that new bone with high density was formed 12weeks after transplant and white cortical bone was seen in the defected area from gross sample while histological sections showed that there were plenty of bone trabecules and the marrow cavity was formed.CONCLUSION: Transplant of autogenous bone marrow stromal stem cells is an ideal method to repair distal bone defect of rabbit radius.
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AIM: To investigate the therapeutic effects of the marine capsules combined with composite Salvia miltiorrhiza dropping pill in treatment with patients with hepatic fibrosis related to chronic hepatitis B. METHODS: 54 patients were enrolled and randomly divided into control group and treatment group. The liver function,the marker of hepatic fibrosis and hepatitis B virus were determined before and after therapy. RESULTS: The markers in this study were significantly improved than those before treatment and those in control group (P
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Background and purpose:Medulloblastoma(MB),which is a primitive neuroectodermal tumor(PNET),is the most common malignant brain tumor of childhood.The mean age at diagnosis is 6 years.Due to the tremendous improvements in techniques of radiotherapy and chemotherapy,the 5-year overall survival(OS) is increased to 70% now,compared with 20% in the 1970s.Factors which include local relapse,whether or not there has occurred metastases before resection,residual tumor and age etc.are mostly considered to have significant effects on prognosis.We studied the effects and side effects of the three dimensional conformal radiation therapy(3D-CRT) for the children with medulloblastoma,and summarized the reasons of failure of the therapy.Methods:From August 2001 to August 2007,34 children with medulloblastoma were treated in our hospital.Among all the patients(3-16 years,mean age was 9.5 years) there were 16 cases in high-risk group,and 18 cases in low-risk group.All of them underwent total or subtotal resection before radiation therapy.Patients were not given radiotherapy and chemotherapy before surgery.The interval between surgery and radiotherapy was less than 3 weeks.The 3D-CRT was done for all the patients with the same techniques:30 Gy to the whole cranialspinal axis followed by a boost of 20-25 Gy to the posterior fossa,witha median fraction dose of 180 cGy.Chemotherapy was given according to the protocol which consisted of lomustine,cisplatinum and vincristine after radiotherapy,but the patients were not given intrathecal chemotherapy.Blood counts and chemistries and renal and hepatic evaluations were performed regularly before every course.Results:5-year OS and 5-year event free survival(EFS) were 71% and 62% respectively.The mean follow-up was 36.5 months.The 5-year OS of the high risk group and low risk group were 88.9% and 50.0% respectively.There was significant difference between them(P=0.01).13 patients were failures.Of all failure patients,3 had recurrence in the region of the cribriform plate.The complete remission was 70.5%,and the partial remission was 14%.If metastases were found before surgery,the 5-year OS was 12.5%(1/8),and if the residual tumor was more than 1.5 cm3,the 5-year OS was 0%(0/5).Whether or not the metastases were found before surgery,and the presence of residual tumor,both had significant impacts on the prognosis of the children with medulloblastoma(P
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AIM: To investigate effects of salvia miltiorrhiza injection on acute myocardial ischemia and hemorheology. METHODS: The acute myocardial ischemia model and blood stasis model were established with high dose adrenaline subcutaneous injection and being socked in ice water. The effect of salvia miltiorrhiza injection on the electrocardiogram J point and T ware of acute myocardial ischemia and the hemorheology of rat blood stasis model were observed. RESULTS: As compared with model groups, middle and high dose groups of salvia miltiorrhiza injection could obviously inhibit the rising of J point and T wave of the ischemic electrocardiogram, all dose groups of salvia miltiorrhiza injection could prevent the ascending of blood viscosity and fibrinogen and hematocrit. CONCLUSION: salvia miltiorrhiza injection can effectively decrease blood viscosity and improve circulatation of coronary artery, and protect ischemic myocardium.
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AIM: To observe the effects of proben-ecid of different doses on pharmacokinetics of cefaclor and to provide the basis of their co-adiministration. METHODS: 30 rabbits were randomly divided into 5 groups: Cef 50 mg?kg -1, Cef 50 mg?kg -1+Pro 50 mg?kg -1,Cef 50 mg?kg -1+Pro 100 mg?kg -1,Cef 50 mg?kg -1+Pro 200 mg?kg -1,Cef 25 mg?kg -1+Pro 100 mg?kg -1. The blood samples were drawn from thigh vein after IG and the concentrations of cefaclor were determined by HPLC. Pharmacokinetics parameters were calculated by NDST procedure. RESULTS: In groups with Cef 50 mg?kg -1, C max and AUC of cefaclor increased, and Vd/F and Cl/F decreased progressively with the adding probenecid. There was no significant difference between Cef 25 mg+Pro 100 mg and Cef 50 mg?kg -1 in each parameter except Cl/F. CONCLUSION: Probenecid can remarkably alter the pharmacokinetics of cefaclor and the magnitude of the effects of probenecid is dependent on its dose in this trial. Cef 25 mg?kg -1 with Pro 100 mg?kg -1 can reach the same blood concentration as Cef 50 mg?kg -1 alone.
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Objective To explore oligodendrocyte selective vulnerability in gray matter area and the effect of subhypothermia after transient forebrain ischemia in gerbils.Methods The gerbils model of forebrain ischemia was induced by 15 min bilateral carotid occlusion.All gerbils were divided randomly into sham operation group,ischemic reperfusion group and subhypothermia treatment group (32.5?0.5℃).Immunohistochemistry for cell specific antigens (transferrin,TF) was used to identify oligodendrocyte.Results The density of TF positive oligodendrocyte in the cortex at 1～2 days reperfusion following ischemia decreased remarkably (P