Diagnosis and Treatment of Klebsiella Pneumoniae Combined with Enterobacter Cloacae in Lumbar Intervertebral Space Infection / 中山大学学报(医学科学版)

ObjectiveTo explore the clinical diagnosis and treatment of rare primary lumbar intervertebral space infection with Klebsiella pneumoniae and Enterobacter cloacae， and provide clinical experience for the diagnosis and treatment of this rare spinal infection. MethodsAn elderly male patient with low back pain and numbness in the left lower extremity for more than 7 months， which aggravated for more than 1 week， was diagnosed with lumbar disc herniation after laboratory and imaging examinations. After admission， the symptoms became acutely aggravated， and re-examination of lumbar enhanced MRI showed local enhancement at the posterior edge of the L3/4 intervertebral space. The VAS score was 9 points， and the lumbar JOA score was 6 points. A posterior lumbar interbody fusion of L3-L5 was performed， and L3/4 intervertebral disc specimens were collected during the operation for bacterial culture. ResultsBacterial culture results showed Klebsiella pneumoniae and Enterobacter cloacae infection. The patient was treated with sensitive antibiotics for 6 weeks after the operation， and the patient was cured during the follow-up of half a year after the operation. ConclusionFor middle-aged and elderly patients with clinical manifestations of acute severe low back pain or lower extremity pain， the possibility of spinal infection should be considered when routine laboratory and imaging examinations suggest lumbar degenerative diseases.

Occupational health risk assessment in a resin anchorage production workshop / 中国职业医学

OBJECTIVE: To compare the applicability of three risk assessment methods on occupational health risk assessment of chemical harmful factors in a resin anchorage production workshop. METHODS: A resin anchoring agent production workshop was selected as the research subject using the judgment sampling method. Contact ratio assessment method and comprehensive index method(both are semi-quantitative evaluation method) and qualitative risk assessment method were applied to estimate the occupational health risks of jobs involved with styrene, dibutyl phthalate and phthalic anhydride. The assessment was carried out, and the obtained risk level was standardized as the risk ratio. The evaluation results of these three methods were compared. RESULTS: The assessment results of exposure ratio method were 1-3, and those of comprehensive index method were 2-3. The risk ratio of the above methods after standardization is consistent with that before standardization. The result of qualitative risk assessment was 2-3, and the risk ratio after standardization was 3-4. The risk ratio after standardization was 1 level higher than that before standardization. Kappa analysis results showed that the result of contact ratio method and the comprehensive index method was in good agreement(Kappa=0.53, P<0.05). The qualitative risk assessment method was inconsistent with the contact ratio method and the comprehensive index method(Kappa values were 0.19 and 0.40, both P<0.05). CONCLUSION: Comprehensive index method is the preferred method for occupational health risk assessment of anchorage agent production workshop under the condition that detection results of occupational hazards can be obtained. Qualitative risk assessment method can be used when the test results cannot be obtained.

High-resolution MRI imaging in patients with middle cerebral artery stenosis / 医疗卫生装备

Object To compare images of the vessel wall between symptomatic and asymptomatic atherosclerotic plaques of the middle cerebral artery (MCA) using high resolution magnetic resonance imaging (HR MRI).Methods HR MRI data were acquired in 36 patients with MCA atherosclerotic stenosis (≥50％) confirmed by MRA, CTA, of whom, 25 symptomatic patients and 11 asymptomatic ones were enrolled into a symptomatic group and an asymptomatic group respectively. The wall thickness and cross-sectional area of stenotic segments were measured and compared between the two groups. The data were analyzed by SPSS 17.0 statistical software.Results The cross-sectional area in the symptomatic group was (3.04±1.03)mm2,while the asymptomatic group was (3.28±0.96)mm2, and the difference between the two groups was not statistically significant (P>0.05). The symptomatic group had a larger wall thickness ((2.32±0.61)mm) when compared with the asymptomatic group ((2.10±0.77)mm), and higher prevalence of plaque enhancement after contrast injection (83.3％).Conclusion Different vessel wall properties on HR MRI are observed between symptomatic and asymptomatic MCA stenosis. Symptomatic MCA stenosis has a larger wall thickness and higher prevalence of plaque enhancement after contrast injection when compared with the asymptomatic.

Clinical observation on injection of small dose of morphine into Neiguan (PC 6) for treatment of chest pain in the patient with acute myocardial infarction / 中国针灸

<p><b>OBJECTIVE</b>To probe into an effective injection way of Morphine for treatment of chest pain of acute cardiac infarction.</p><p><b>METHODS</b>Ninety cases of myocardial infarction were randomly divided into 3 groups, an acupoint-injection group, an intravenous injection group and a hypodermic injection group, 30 cases in each group. The acupoint-injection group were treated with injection of 2 mg Morphine into bilateral Neiguan (PC 6) respectively, and the intravenous injection group with intravenous injection of 5 mg Morphine and the hypodermic injection group with hypodermic injection of 5 mg Morphine, and other treatments were same in the 3 groups. The analgesic effects were assessed with visual analogue scale (VAS) 5, 10, 30, 60 and 180 minutes after treatment and the complications were observed.</p><p><b>RESULTS</b>There were no significant differences among the 3 groups before treatment in the VAS score (P > 0.05). The analgesic effect in the acupoint-injection group was better than those in other two groups 5 min, 30 min and 180 min after treatment (all P < 0.01). The incidence rate of nausea and vomiting of 0.3% in the acupoint-injection group was significantly lower than 40.0% in the intravenous injection group and 20.0% in the hy podermic injection group (all P < 0.01).</p><p><b>CONCLUSION</b>Injection of small dose of Morphine into Neiguan (PC 6) has a definite therapeutic effect on chest pain of acute myocardial infarction with earlier analgesic effect, smaller dose of Morphine, longer analgesic duration and less complications.</p>

Association of 86 bp variable number tandem repeat polymorphism of interleukin-1 receptor antagonist gene with lumbar disc disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the association of 86 bp variable number tandem repeat (VNTR) polymorphism of interleukin-1 receptor antagonist (IL-1Ra) gene with lumbar disc disease and intervertebral disc degeneration.</p><p><b>METHODS</b>The 86 bp VNTR polymorphism of IL-1Ra gene was analyzed with PCR and electrophoresis for 81 patients with lumbar disc disease and 101 volunteers without sciatica (control). The grade of intervertebral disc degeneration was determined with magnetic resonance imaging, and the association of 86 bp VNTR polymorphisms with lumbar disc disease and intervertebral disc degeneration in those younger than 45 years was assessed.</p><p><b>RESULTS</b>The presence of 86bp VNTR polymorphisms of IL-1Ra gene was detected in both patients with lumbar disc disease and the control subjects. The distribution of 86 bp VNTR polymorphisms of IL-1Ra gene showed no significant difference between the two groups, but the distributions of 1/1, 1/2 and 2/2 or 1, 2 genotypes differed significantly. The current data did not support a significant association between the distribution of IL-1Ra gene 86bp VNTR polymorphism and lumbar disc degeneration.</p><p><b>CONCLUSIONS</b>IL-1Ra gene 86bp VNTR polymorphism is present among Chinese population in association with lumbar disc disease, but not with lumbar disc degeneration.</p>

The post-injury regenerating ability of temporomandibular joint of rats exposed to the repeated + Gz forces / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To observe the post-injury regenerating ability of temporomandibular joint of rats exposed to the repeated + Gz forces.</p><p><b>METHODS</b>One hundred and eight male rats were randomly assigned to 9 groups, with 12 rats in each group. Group A was normally fed serving as the blank control group. Group B was only fixed with rat-kept devices for 5 minutes as the fixed control group. Group C was borne +1 Gz for 5 minutes. In the same position as group C, group D, E, F, G, H and I were repeatedly exposed to +10 Gz for 30 seconds each time with 5 times a day and +1 Gz for 1 minutes as a interval. The 6 groups were treated in the condition above for 4 days a week and 4 weeks in total. The rats in group A, B, C and D were killed on the next day after the centrifuge. The rats in group E, F, G, H and I were killed at 1, 2, 4, 8 and 12 weeks after the centrifuge, respectively. After the rats were killed, temporomandibular joint were taken for observation under optical microscope, scanning electron-microscope (SEM) and transmission electron-microscope (TEM).</p><p><b>RESULTS</b>There was no significant difference observed in group A, B and C. But in group D, E, F, G, H and I pathologic injuries and self-regeneration were seen in TMJ in different degrees.</p><p><b>CONCLUSIONS</b>The injury of TMJ could regenerate gradually with time.</p>

The application of METRx microendoscopes diskectomy system in the treatment of far lateral lumbar disc herniation / 中华外科杂志

<p><b>OBJECTIVE</b>To introduce the METRx microendoscopes diskectomy system in the treatment of far lateral lumbar disc herniation.</p><p><b>METHODS</b>Fourteen cases of far lateral lumbar disc herniation were operated with METRx from February 1999 to December 2002. Among them, the average age was 49 years old (range 41 - 55 years old), male in 10 cases, female in 4 cases. All cases were single disc herniation; L(4), 5 herniation in 6 discs, L(5)-S(1) herniation in 8 discs; foraminal disc herniation in 6 cases, extra-foraminal disc herniation in 8 cases.</p><p><b>RESULTS</b>All the cases were followed up from 12 to 46 months (average 26.5 months) with the results of excellence in 10 cases, good in 3 cases, fair in 1 case and no failure case. There were no disc infection, dura laceration, nerve root injury and herniation recurrence.</p><p><b>CONCLUSIONS</b>METRx is suitable for far lateral lumbar disc herniation with the advantages of minimal invasive, complete decompression of nerve root and rapid recovery. The correct approach and precise surgical technique are the key points for this operation.</p>

Pharmacodynamic tests of wulong kangai on transplantable tumors in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the pharmacodynamic and side effects of Wulong Kangai, a new drug of Chinese traditional herbal medicine, on 4 strains of mice transplantable tumors.</p><p><b>METHOD</b>Mice transplantable tumors S180, H22, P388 and Lewis were used in the pharmacodynamic test on the granules of Wulong Kangai. The test on each tumor strain was repeated three times. In each test, 50 mice were used and divided into 5 groups. They were negative control group treated by physiological saline, cyclophosphamide control group and 3 test groups treated respectively with Wulong Kangai at deferent dosages of 10, 25, 40 g x kg(-1) x d(-1) in the treatment of Lewis and P388 and 15, 30, 50 g x kg(-1) x d(-1) in the treatment of S180 and H22.</p><p><b>RESULT</b>The tumor weight were inhibited at the rates of 90.1%, 30.8%, 49.8% and 52. 3% in the mice with tumors of Lewis, P388, S180, and H22 by high dosage of Wulong Kangai as compared with negative control group. The inhibitory rates in cyclophosphamide groups were 90.6%, 77.2%, 79.6% and 60.3% respectively. The mice body weights grew slower in high dose groups treated by Wulong Kangai granule.</p><p><b>CONCLUSION</b>Wulong Kangai was effective in treating mice transplantable tumors of Lewis, P388, S180 and H22 with a dose-dependent manner. The Lewis was the most sensitive strain to the drug among the 4 kinds of tested tumors. Side effects appeared during 9-11 days of uninterrupted treatment with high dose Wulong Kangai.</p>

Design and experiment of the pedicle aiming device for the cervical spine / 中国医学科学院学报

<p><b>OBJECTIVE</b>To probe the accuracy and safety of using an aiming device in the transpedicular fixation of cervical spine.</p><p><b>METHODS</b>Eight cervical specimens were obtained. We used the computed tomography (CT) to scan C3 to C7, measured the medial angle of the pedicle, and determined the location of the pedicle projecting on the articular process. Then we took the oblique X-ray film, measured the cephalic/caudal angle of the pedicle, and determined the location of the pedicle projecting on the articular process. All the specimens were equally divided into two groups. Screws of 2.8 mm x 30 mm, were used. Specimens in one group were inserted with the transpedicular screw manually, while specimens in the other one inserted with the transpedicular screw using a self-designed aiming device that can be modulate at the three dimensions according to the angles of the pedicles.</p><p><b>RESULTS</b>The first group totally had 40 screws from C3 to C7. There were 13 screws in the pedicle, 9 violated the walls of the pedicle but not involved the adjunct structure, and 18 injured the important structure such as spinal cord, verteberal artery, or nerve root. In the other group, only 4 screws violated the walls of the pedicle but not involved the adjunct structure, and the others all in the pedicles. The difference was of statistical significance (P < 0.01).</p><p><b>CONCLUSION</b>In the cervical spine, transpedicular fixation using an aiming device can improve the accuracy and safety during operation.</p>

Aberrant expression and deletion of FHIT gene in leukemias / 中国实验血液学杂志

FHIT (fragile histidine triad) gene at chromosome 3p14.2 usually expresses at a very low level in human tissue and cells. A high frequency of abnormalities in FHIT gene has been demonstrated in various cancers. FHIT is proposed as a putative tumor-suppressor gene. To evaluate the expression of the FHIT gene in various leukemias, bone marrow or peripheral blood samples from 98 leukemia patients were tested by RT-PCR: 38 from patients with AML-[M(2)(9), M(3)(12), M(4)(8), M(5)(9)], 16 with ALL, and 34 with CML-[CP(20), AP(4), BC(10)] of various FAB types, as well as 10 patients with other hematological malignancies. To detect a deletion in sequencing the FHIT gene, the representative aberrant PCR products were cloned and then sequenced. The results showed that 22/38 (58%) patients with AML, 9/16 (56%) patients with ALL and 19/34 (56%) patients with CML were detectable of aberrant FHIT mRNA transcripts or deletion of FHIT. In 6 (16%) AML patients, 3 (19%) ALL patients, and 5 (15%) CML patients, the wild-type product was absent. Some patient's samples - 6 (42%) AML, 6 (38%) ALL, and 14 (41%) CML revealed aberrant FHIT transcripts in addition to a normal-sized band. Samples from healthy donors (PB, n = 12; BM, n = 5) did not indicate any abnormal expression. Eleven isolated fragments from various patterns of FHIT gene expression were investigated using cDNA sequencing. Sequence analysis revealed deletion of exon 4-8, exon 5-8, and exon 5-6 in various leukemias, as well as the deletion of the full FHIT gene sequence. The fused transcripts included: exon 3 and exon 9, exon 3 and exon 7, exon 4 and exon 9, exon 5 and exon 7. Sequence analysis of aberrant fragments present in samples from an AML and a CML patients was detected for point mutations and insert mutations located in exons 2, 8 and 10, plus a variety of aberrant transcripts. Deletion or aberrant FHIT mRNA transcripts in 50/98 (51%) leukemia patients were found. All samples with aberrant FHIT lacked gene product. A Kaplan-Meier plot of survival in patients with AML in relation to FHIT expression revealed that aberrance or loss of FHIT gene significantly correlated with a low clinical remission rate and poor overall survival.

Soluble expression of peptide containing MUC1/Y-specific epitope in Escherichia coli and preparation of the antibody / 生物工程学报

MUC1 mucin is a high molecular weight, type I transmembrane glycoprotein. High and aberrant expression of MUC1 is observed in various types of tumors, which make it an ideal target for tumor biotherapy as well as a biomarker for tumor diagnosis and prognosis. MUC1/Y is an isoform of MUC1 generated by alternative splicing. Specific expression of MUC1/Y in breast cancer as well as its involvement in tumor cell signal transduction have been reported. In order to purify peptides containing MUC1/Y-specific epitope in E. coli and prepare MUC1/Y-specific antibody, DNA fragment encoding the MUC1/Y-specific peptide was amplified by PCR using MUC1/Y full length cDNA as the template and cloned into fusion expression vector pGEX-2T, resulting pGEX-Y30. DNA sequencing was performed to confirm the correct amplification and orientation of the target sequence. Competent E. coli DH5alpha was transformed with pGEX-Y30 and the expression was induced for 4-5 hours in 0.2 mmol/L IPTG at 30 degrees C and 37 degrees C. Expressed proteins were released from the cells by ultrasonication or B-PER II reagent treatments. The fusion protein GST-Y30 were purified by affinity and anion exchange columns and identified by SDS-PAGE and Western-blotting. Polyclonal antibody was prepared by immunizing rabbits with the GST-Y30 protein for 4 times with intervals of 3 weeks and purified by GST column. Western blotting, ELISA and immunohistochemistry analysis were carried out using the purified antibody to confirm its MUC1/Y-binding capacity and specificity. The expressed fusion protein GST-Y30 is about 31 kD in size and represented about 20% of total cellular proteins. The majority of the GST-Y30 protein existed as soluble form when the induction was carried out at both 30 degrees C and 37 degrees C. After the two-step purification, the purity of GST-Y30 was about 94%. The titer of polyserum generated by GST-Y30 immunization was 1:320,000 by ELISA. The antiserum showed MUC1/Y specificity and can recognize MUC1/Y on MCF7 cell. The MUC1/Y-specific polyclonal antibody can be used for studying the role of MUC1/Y in carcinogenesis.

Expression of GST-pi and MDR1 genes in operative specimens of ovarian cancer / 军事医学科学院院刊

Objectives:To study the expression of GST-pi and MDR1 genes in operative specimens of ovarian cancer,and to analyze the possible clinical role of GST-pi and MDR1. Methods:Eighteen frozen specimens of ovarian carcinoma and ten specimens of normal ovarian tissues from patients were examined for the expression of GST-pi and MDR1 genes by means of RT-PCR, and quantitative analysis was performed using β-actin as internal contrast.Results: Positive expression rate of GST-pi and MDR1 in ovarian carcinoma were 61.1% and 33.3%,respectively,and in contrast, 20% and 10% in normal ovarian tissues respectively. The level of GST-pi gene expression in ovarian carcinoma was obviously higher than that in normal ovarian tissue (P<0.05)and MDR1 gene also had high level expression in ovarian carcinoma, but had no statistical significantance. Four patients with ovarian carcinoma had GST-pi and MDR1 coexpression. Expression levels of GST-pi mRNA were lower than that of protein. Conclusions: (1) GST-pi and MDR1 had higher level expression in ovarian carcinoma than in normal ovarian tissues. (2) GST-pi and MDR1 may have same regulating factors but different mechanisms of action. (3)Processing after transcription and/or regulation of translation level may exist in GST-pi expression.