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The authors report a successful outcome after percutaneous transabdominal placement of a self-expandable metallic stent in a patient who had afferent loop syndrome caused by recurrent common bile duct adenocarcinoma. Enhanced abdominal CT showed marked dilation of the afferent loop adjacent to the anterior peritoneum, multiple hepatic metastases and lymph node metastasis around the choledochojejunal anastomosis site without marked dilation of intrahepatic bile ducts. Percutaneous drainage catheter was successfully placed to the dilated afferent loop just below the abdominal wall. Subsequent successful palliation of the afferent loop obstruction was achieved by placing a self-expandable metallic stent via the transabdominal route with the aid of cone-beam CT.
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OBJECTIVE:To observe clinical efficacy and safety of alprostadil combined with salvia ligustrazine in the treat-ment of aged patrents with unstable angina pectoris. METHODS:A total of 150 patients with unstable angina pectoris department of our hospital during Oct. 2011-Mar. 2015 were randomly divided into alprostadil group,salvia ligustrazine group and combination group according to random number table,with 50 cases in each group. Three groups received routine treatment. Alprostadil group additionally received Alprostadil injection 100 μg added into 0.9％ Sodium chloride injection 250 mL,ivgtt,qd,on the basis of routine treatment. Salvia ligustrazine group additionally received Salvia ligustrazine injection 10 mL added into 0.9％ Sodium chlo-ride injection 250 mL,ivgtt,qd,on the basis of routine treatment. Combination group additionally received constant dose of Al-prostadil injection and Salvia ligustrazine injection. Hemorheological indexes (high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit,fibrinogen),cardiac function indexes(LVEF,SV,LVEFD,LVST),serum CRP, NO,ET,SOD and clinical efficacies were observed in 2 groups before and after treatment;the occurrence of ADR was compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in hemorheological indexes,cardiac function indexes or serum CRP,NO,ET,SOD level between 2 groups (P>0.05). After treatment,plasma viscosity,the whole blood high and low shear viscosity,hematocrit,fibrinogen,serum CRP and ET levels of 3 groups were decreased significantly,while LVEF,SV,serum levels of NO and SOD were increased significantly,combination group was significantly better than alprostadil group and salvia ligustrazine group,with statistical significance (P0.05). CONCLUSIONS:Alprostadil combined with salvia ligustrazine can effectively reduce the blood viscosity of patients with unstable angina pectoris,improve cardi-ac function and endothelial function,reduce myocardial ischemia injury and show significant therapeutic efficacy and safety without increasing the incidence of ADR.
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Life course epidemiology should practically illustrate how risk exposures and their dynamic changes influence the occurrence, development and prognosis of chronic diseases from early life to the elderly. This paper develops the lifespan risk exposure measurement instrument (LREMI) in the framework of retrospective study to collect lifestyle, diet, physical activity information across subjects'life courses from 18-years-old to current age. Through a pilot study, the result of the test-retest analysis demonstrated the reliability of LREMI. In Shandong Multicenter Cohort, the LREMI showed its feasibility, for it could measure the exposure spectrum on both individuals and population with different life experiences. Moreover, it had good differentiation ability for identifying cases versus controls in population-based case-control study. However, further studies should be conducted in an already available prospective cohort to ascertain that our results could match prospective data.
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Humans , Environmental Exposure , Epidemiologic Methods , Life Style , Retrospective StudiesABSTRACT
ABSTRACT The fruit of the Prunus mume (Siebold) Siebold & Zucc., Rosaceae (Korean name: Maesil) has long been used as a health food or valuable medicinal material in traditional herb medicine in Southeast Asian countries. In this study, we determined the potential therapeutic efficacy of the ethanol extract of P. mume fruits (EEPM) against H2O2-induced oxidative stress and apoptosis in the murine skeletal muscle myoblast cell line C2C12, and sought to understand the associated molecular mechanisms. The results indicated that exposure of C2C12 cells to H2O2 caused a reduction in cell viability by increasing the generation of intracellular reactive oxygen species and by disrupting mitochondrial membrane permeability, leading to DNA damage and apoptosis. However, pretreatment of the cells with EEPM before H2O2 exposure effectively attenuated these changes, suggesting that EEPM prevented H2O2-induced mitochondria-dependent apoptosis. Furthermore, the increased ex-pression and phosphorylation of nuclear factor erythroid 2-related factor 2 (Nrf2) and up-regulation of heme oxygenase-1 (HO-1), a phase II antioxidant enzyme, were detected in EEPM-treated C2C12 cells. We also found that zinc protoporphyrin IX, an HO-1 inhibitor, attenuated the protective effects of EEPM against H2O2-induced reactive oxygen species accumulation and cytotoxicity. Therefore, these results indicate that the activation of the Nrf2/HO-1 pathway might be involved in the protection of EEPM against H2O2-induced cellular oxidative damage. In conclusion, these results show that EEPM contributes to the prevention of oxidative damage and could be used as a nutritional agent for oxidative stress-related diseases.
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<p><b>OBJECTIVE</b>To investigate the stability of internal fixation for femoral neck fracture(FNF) using two or three cannulated screws directed to different fracture lines, and to provide a theoretical basis for the clinical decision making.</p><p><b>METHODS</b>Fifteen fresh frozen human femur samples were selected and the FNF model was established with Pauwels angle of 30°, 50° and 70° respectively. The models were fixed with three or two cannulated screws, and their differences at tensile strength, subsidence, shear strength and composite displacement, gap distance, torsional angle and stiffness values of four types of femur were evaluated to identify their biomechanical stability.</p><p><b>RESULTS</b>With Pauwels angle of 30° and 50°, no statistical differences at the referenced outcomes were observed between two and three cannulated screw fixation for FNF(>0.05). With the Pauwels angle of 70 °, three cannulated screws fixation were significantly superior to two cannulated screws fixation for FNF(<0.05). Nevertheless, when Pauwels angle was 70°, three cannulated screws fixation turned out to be relative instable compared with Pauwels angle of 30° and 50°.</p><p><b>CONCLUSIONS</b>With Pauwels angle of 30° and 50°, two cannulated screws fixation was similarly stable as using three cannulated screws for FNF. Three cannulated screws fixation were obviously superior to two cannulated screws fixation when Pauwels angle was 70°, but the application of three cannulated screws could still be insufficiently stable when only such routine fixations were utilized. Therefore, Angle Stabilizing System or anti-sliding screws were needed to enhance the stability of FNF fixation.</p>
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Objective To understand the syphilis infection status of high-risk population in Yangdu district of Yancheng city so as to provide a scientific basis for preventive and intervention measures.Methods Serum anti-TP antibody was detected by the en-zyme-linked immunosorbent assays(ELISA).Treponema pallidum particle agglutination(TPPA)assay was carried out on the posi-tive samples of anti-TP antibody,then rapid plasma regain(RPR)was conducted on the positive ones.Results The syphilis antibody positive rate of high-risk population was 14.30%,among them the positive rate of RPR in the syphilis infected persons was 58.18%;the positive rate of syphilis had statistically significant difference between genders in different crowds and different age groups(P <0.05).Conclusion The syphilis infection rate of high-risk population in Yandu district is high.The infection rates of STD clinic clients and the people subjected to reeducation were higher than those of the person accepting voluntary counseling and testing(VCT);the infection rate of 21-40 years old females is significantly higher than that of males.The high-risk population mo-nitoring should be strengthened and the publicity and education and behavior intervention should be carried out to effectively re-strain the spread of syphilis in crowds.
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<p><b>OBJECTIVE</b>To investigate the cause of failure after autogenous bone graft with limb fracture nonunion,to explore the major influencing factor of the treatment, and to research the evidence for improving the treatment of nonunion.</p><p><b>METHODS</b>A retrospective analysis was done with 367 cases suffering from autogenous bone graft surgery after limb fracture nonunion between January 1995 to December 2011. Among them,there were 198 males and 169 females aged 12 to 89 years (means 53.5 years) with duration of 23 to 49 months. The treatment effect assessed with X-ray and CT after grafting in the treatment, and 32 cases were detected nonunion again, and others' fixations were dismantled by operation after fracture healing. The following correlation including factorsages,gender,smoking, nutritional status during therapy,classification of primary fracture,location of fracture, type of nonunion, changing the type of fixation,type of fixation and complicating disease were evaluated by Logistic stepwise regression to discover the influencing factors of the failure of union.</p><p><b>RESULTS</b>The treatment failure rate was 8.72% in the patients with surgery and graft included in the statistics for the late re-admitted in 6 to 12 months followed-up. Smoking, classification of primary fracture, type of nonunion, changing the type of fixation, complicating disease had influence to incidence rate of union after autogenous bone graft.</p><p><b>CONCLUSION</b>Autogenous bone graft is the utility method for limb fracture nonunion. Smoking, classification of primary fracture, classification of nonunion,changing the type of fixation, complicating disease are the risk factors of nonunion after graft. Patients should be advised to stop smoking in the nonunion bone graft. And at the same time, the treatment of related diseases, analysis of the original fracture and nonunion,aggressive treatment of infection, and developing better surgical solutions before surgery, as well as changing the fixation methods can reduce the risk of failure of the graft.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Bone Transplantation , Extremities , Wounds and Injuries , Fracture Fixation , Fracture Healing , Fractures, Ununited , General Surgery , Transplantation, Autologous , Treatment FailureABSTRACT
OBJECTIVE To study risk factors in senile diabetics complicated with urinary tract infections and find out measures to cut down the incidence rate with urinary tract infection.METHODS The age,sex,hospital day,course of diabetes,blood sugar level and catheterization in 181 hospital patients of senile diabetics complicated with urinary tract infections from 2004 to 2007 were analyzed retrospectively.RESULTS The incidence of senile diabetics complicated with urinary tract infections was closely related with age,sex,hospitalization days,course of diabetes,blood sugar level and catheterization.CONCLUSIONS Control measure for risk factors in senile diabetics can actively cut down the incidence rate of urinary tract infection.