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Objective To formulate and standardized the procedure of bowl preparation before transrectal ultrasound-guided prostate biopsy. Methods The standardized transrectal ultrasound-guided prostate biopsy flowchart were formulated based on the best evidences and recommendations. One hundred and forty patients selected with suspected of prostate cancer and scheduled for transrectal ultrasound-guided prostate biopsy was equally assigned to two groups, the control group was given routine hospital practice before biopsy, and the observation group followed the formulated flowchart. Monitoring two groups for complications, time cost for bowl preparation, medical billing and the average day of hospitalization. Results The incidence of complications and the number of hospitalization days between two groups were comparable, the observation group in bowl preparation time was (3.75 ± 0.78) min, the control group in bowl preparation time was (11.88 ± 1.93) min, the difference of two groups showed statistical significance (t=15.643, P<0.01). The observation group in medical bill was￥(81.62±15.62), the control group in medical bill was ￥(427.78 ± 76.87), the difference of two groups showed statistical significance (t=-36.964, P<0.01). Conclusions Application of evidence-based practice to formalize bowl preparation and antibiotic use in transrectal ultrasound-guided prostate biopsy patient can facilitate the clinical nurses to provide homogenized care to prostate biopsy patients as well as improve the efficiency of nursing work.
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ObjectiveTo analyze the relationship between serum total bilirubin coincident with congestive heart failure (CHF) exacerbation and subsequent long-term mortality in patients with CHF.MethodsThe study population consisted of 140 consecutive patients admitted for CHF exacerbation with left ventricular ejection fraction ≤45％.They were divided into 2 groups according to whether death attacked or not in the following 28.5 months. Binary logistic regression analysis was used to investigate independent predictors of death from clinical parameters on admission or within 24 hours. ResultsSerum TBil and B-type natriuretic peptide (BNP) levels on admission were independent predictors of subsequent death after hospital discharge.According to increasing textiles of TBil stratified by the level of 12.8 and 18.2 mmol/L,the patients were divided into 3 groups:lower-level group (TBil ≤ 12.8 mmol/L),moderate-level group (TBil ＞ 12.8 ～ 18.2 mmol/L) and higher-level group (TBil ＞ 18.2 mmoL/L),with the death rates after 28.5 months of 12.2％,17.9％ and 38.9％,respectively ( P =0.002 ). Meanwhile,the pulse pressure decreased to (55.5 ± 17.3) mm Hg (1 mm Hg =0.133 kPa),(48.9 ± 13.1) mm Hg and (46.1 ± 13.7)mm Hg,respectively ( P =0.008 ). TBil on admission had significant correlation with echocardiographymeasured left ventricular endo-diastolic diameter ( r =0.34,P =0.000 ) and right ventricular diastolic diameter (r =0.23,P =0.011 ). ConclusionsIncreased TBil coincident with cardiac decompensation predicts a worse long-term death of CHF,presumably through the potential liability to both decompensated RV function and lower cardiac output syndrome occurred simultaneously when HF deteriorates.
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Objective To evaluate effect of combined corpeetomy for multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL).Methods Fifteen patients with CSM or OPLL,including 9 males and 6 females,were treated with combined corpectomy which is characterized by C4 and C6 corpectomy,excision of osteophyma,protruded disc and/or ossified posterior longitudinal ligament on basis of preservation of C5 vertebral body,structural bone grafting in C3-5 and C5-7,and anterior cervical plate fixation at C3,C5,and C7.The clinical results were evaluated with Japanese Orthopaedic Association (JOA) score.X-rays and CT scans were taken to evaluate vertebral fusion,and MRI was used to access spinal canal decompression and condition of spinal cord.Results All patients were followed up for 9 to 42 months (average,26.7 months).Bony fusion was achieved in all 15 patients.The JOA score improved from preoperative 13.44±2.81 to postoperative 16.16±2.19 (P=0.0354).The cervical lordosis improved from preoperative 1.16°±11.74° to immediately postoperative 14.36°±7.85° (P=0.00217),and 12.92°+6.17° at the final follow-up (P=0.00292).The complications included temporary hoarseness in 2 cases,dysphagia in 1 case.Conclusion The combined corpectomy for treating CSM and OPLL can obtain reliable and satisfactory results.In operation,the preservation of C5 vertebral body can provide an additional screw anchoring force and strengthen stahility.
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OBJECTIVE@#To determine the characteristics, classification, and treatment of thoracic fracture accompanied with sternum fracture.@*METHODS@#Data of 32 patients with thoracic fractures accompanied with sternum fracture were reviewed. Patients information such as age, gender, cause of injury, site of sternum fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries was included in the analysis. Of the 32 patients, 13 had compressed fractures, 13 had fracture-dislocations, 5 had burst fracture and 1 had burst-dislocation. Six patients had a complete lesion of the spinal cord, 13 sustained a neurologically incomplete injury, and the other 13 were neurologically intact. Ten patients were treated nonoperatively and the other 22 surgically.@*RESULTS@#All patients were followed up for 10-103 months. Road traffic accidents and falling dominated among the causes. All patients were accompanied with other injuries. None of the 6 patients with a complete paralitic lesion regained any significant function. Of the 13 neurologically intact patients, 5 had local pain although 12 of them remained normal function. One patient showed tardive paralysis. Three of the 13 patients with incomplete paraplegia returned to normal, 5 regained some function and 5 did not recover.@*CONCLUSION@#Thoracic fractures accompanied with sternum fracture are marked by violent force, severe fracture of the spine, severe injuries of the spinal cord, and high incidence of other injuries. The new classification method is more suitable to thoracic fractures accompanied with sternum fracture,and confirms the existence and clinical relevance of the 4th column of the thoracic spine and its role in providing spinal stability in patients with thoracic fracture.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Fracture Fixation, Internal , Methods , Fractures, Bone , Classification , General Surgery , Fractures, Compression , General Surgery , Joint Dislocations , General Surgery , Multiple Trauma , Classification , Spinal Fractures , Classification , General Surgery , Sternum , Wounds and Injuries , General Surgery , Thoracic Vertebrae , Wounds and Injuries , General SurgeryABSTRACT
AIM: To investigate the role of angiopoietin-1 (Ang1) and Tie2 receptor in angiogenesis after myocardial infarction through detecting their mRNA expression in normal and infracted myocardium. METHODS: The experiment was conducted in the laboratory of Biochemistry and Molecular Biology, Medical Department of Peking University from April 2006 to April 2007. Forty male SD rats were randomly divided into acute myocardial infarction model group and sham-operation group. The myocardial infarction model was established in the rats of model group through the ligation of left anterior descending artery, while the rats in sham operation group were braided of the left anterior descending artery without ligation. Five rats in both groups were executed at 3, 7, 14, and 28 days after model establishment. RNA was extracted from the same site of left anterior wall, and the polymerase chain reaction was used to semiquantitatively analyze the Ang1 and Tie2 receptor mRNA expression with GAPDH gene as internal control; meanwhile, the immunohistochemistry was used to detect vascular density in and around infarction area. All the treatments for animals were accorded with the animal ethical standards. RESULTS: All 40 rats were included in the final analysis. Both Ang1 and Tie2 receptor were expressed in normal myocardium. In the 28 days after myocardial infarction, Ang1 expression kept at almost the same level without changing, but Tie2 receptor expression was slightly elevated at 3 days, reached peak value at 7 days, and returned to the baseline value at 14 days. The vascular density increased both infarction and peri-infarction area at 7 days after acute myocardial infarction, and did not change with time. CONCLUSION: Tie2 receptor expression is elevated and coincided with angiogenesis after myocardial infarction. It may play a role in the development and stabilization of the blood vessel after myocardial infarction.
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[Objective]To investigate the surgical method and clinical effects of the anterior approach operation in the treatment of thoraco-lumbar vertebral fractures through limited incision.[Method]Thirty-four cases of bursting fracture of thoracolumbar vertebral body were treated with the operation of anterior decompression,bone grafting and internal fixation by the anterior retropleuro-peritoneum approach.The MRI combined with clinical examination,X-ray,CT results were taken as selection criteria of treatment.[Result]Thirty-four cases were treated with this operative technich.Hemorrhage capacity is about 300-800ml with average 600ml.The operation time was 2-2.5 hours.All patients were followed-up with an average period of 18 months(ranged,6-24months).No aggravation of nerve injury appeared in 34 cases.X-ray manifested good fusion,no broken nails and no recurrence of kyphosis was found in all cases.[Conclusion]Anterior approach operation through limited incision is an effective way for severe thoracolumbar fractures. It has significantly low complication and allow early recovery of function.
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AIM To study the apoptosis and characterizati on of cultured vascular smooth muscle cells (VSMCs) induced by cholestan-3β,5 α,6β-triol(Triol) and compared with 25-hydryoxycholestrol(25-OH). M ETHODS The culture of vascular muscle smooth cells (VSMCs), light and e lectron transmission microscopy and TdT-mediated dUPT nick-end labeling (TUNEL ) technique. RESULTS After being treated with oxyterols, VSMCs showed apoptosis of ultrastracture change including shrinkage, condensation of nuclear chromatin, fragmentation nuclei and formation of apoptotic body. TUNEL r evealed that Triol-induced apoptosis in VSMCs was in a concentration-dependent manner. The effect of Triol and 25-OH at a 30 μmol*L-1 concentration i n culture medium induced apoptosis of VSMCs, the former was not but the latter was inhibited by cholesterol at a 50 μmol*L-1 concentration. CO NCLUSION Triol can induce VSMCs apoptosis in vitro and oxysterol-i nduced apoptosis in VSMCs may be mediated through various pathway and different mechanism. Oxysterol-induced apoptosis in VSMCs may play an important role in t riggering atherosclerosis plaque rupture and result to the onset of the acute co ronary syndromes.
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AIM: To investigate the effects of oxysterols on matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase-1 (TIMP-1) expression in vascular smooth muscle cells. METHODS: Rabbit aortic vascular smooth muscle cells were cultured in vitro and incubated with cholesterol, Triol and 25-hydroxycholesterol (25-OH), respectively. Slot blot was used to detect the mRNA expression level of TIMP-1 in vascular smooth muscle cells (VSMCs); meanwhile the protein expression level of MMP-9 and TIMP-1 was detected by immunohistology. RESULTS: Triol and 25-OH inhibited the expression of TIMP-1 compared with control and cholesterol, but have no effect on expression of MMP-9. CONCLUSION: Both Triol and 25-OH downregulated TIMP-1 expression in VSMCs .
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AIM: To investigate the apoptosis of endothelial cells (EC) induced by oxysterols and to examine the effect of amlodipine on the apoptosis induced by oxysterols.METHODS: Light microscope, electron microscope, DNA agarose gel electrophoresis and flow cytometry were used to detect the apoptosis of EC.RESULTS: The characteristic morphological features of apoptosis were observed under light and electron microscope; DNA electrophoresis showed"DNA Ladder"; Flow cytometry showed the sub-G1 peak, apoptotic rate is 32.25% and 23.04% in Triol-treated and 25-OH-treated groups, respectively. While treated EC with amlodipine at the same time, the apoptotic rate decreased significantly. CONCLUSION: Both Triol and 25-OH can induce apoptosis of EC, which can be inhibited by amlodipine.