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Objective:To evaluate the changes in foveal avascular zone (FAZ) size and foveal microstructures in patients with rhegmatogenous retinal detachment (RRD) and to analyze the correlation between FAZ size, foveal microstructure changes and visual outcomes.Methods:A retrospective study. From January 2017 to January 2019, 79 RRD patients (79 eyes) diagnosed in Department of Ophthalmology in Baoding First Central Hospital were included in the study. The patients were divided into macula-off group (51 eyes), macula-on group (28 eyes). The unaffected fellow eyes were used as a control group. The retinas were reattachment in all eyes after first standard 23G PPV combined with silicone oil filling. Before and 3 months after surgery, all patients underwent a comprehensive ophthalmologic examination, including the measurement of BCVA and OCT angiography (OCTA) examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The FAZ areas were evaluated with OCTA in the superficial capillary plexus layers by using 3 mm×3 mm images of the macular.The following postoperative foveal microstructures were evaluated:epiretinal membranes, macular edema, subretinal fluids, integrity of ellipsoidal zone and external limiting membrane. Pearson correlation analysis was used to analyze the correlation between FAZ area and BCVA. The correlation between macular microstructures and BCVA was analyzed by Spearman correlation analysis.Results:At 3 months after the removal of silicone oil, the FAZ area in the macula-off group, macula-on group and the control group were 0.447±0.041, 0.409±0.034, 0.335±0.027 mm 2, respectively. Compared with the control group, the FAZ area in the macula-off group and macula-on group were enlarged, the difference was statistically significant ( F=184.148, P<0.05). The logMAR BCVA in the macula-off group and macula-on group were 0.800±0.180 and 0.386±0.160, respectively. There was significant difference in ellipsoidal zone rupture between the two groups ( χ 2=7.577, P=0.006). The results of correlation analysis showed that the area of FAZ and the incidence of ellipsoidal zone fracture after surgery were positively correlated with BCVA after surgery ( r=0.329, 0.290; P=0.003, 0.010). Conclusions:The FAZ area of RRD is enlarged after surgery. FAZ area and ellipsoid zone fracture are positively correlated with BCVA after surgery.
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Objective To explore the application value of the liver stiffness measurement (LSM) on complications after hepatectomy.Methods The retrospective case-control study was conducted.The clinical data of 121 hepatocellular carcinoma (HCC) patients who underwent hepatectomy in the Mianyang Central Hospital from January 2011 to April 2017 were collected.All 121 patients received LSM using Fibro Scan,and 81 undergoing laparoscopic liver resection (LR) and 40 undergoing open liver resection (OR) were respectively allocated into the LR and OR groups.Observation indicators:(1) comparisons of intra-and post-operative situations;(2) risk factors analysis affecting postoperative complication of HCC patients;(3) area under the curve (AUC) of LSM and postoperative complications;(4) comparisons of intra-and post-operative situations,when LSM ≤17.5 kPa;(5) comparisons of intra-and post-operative situations,when LSM ＞ 17.5 kPa;(6)comparisons of intra-and post-operative situations between patients with LSM ≤ 17.5 kPa and LSM ＞ 17.5 kPa in the LR group.Measurement data were represented as x±s,and mean comparisons between groups were done using the t test.Comparisons of count data and univariate analysis were analyzed using the chi-square test and Fisher exact probability.The multivariate analysis was done using the logistic regression model,using P＜0.01 as a inclusion criteria in the univariate analysis.The critical value of postoperative complication was calculated using the receiver operating characteristic curve (ROC).Results (1) Comparisons of intra-and post-operative situations:all the 121 patients underwent successful surgery,including 4 with conversion to open surgery in the LR group.Cases with Pringle manner were 51 in the LR group and 17 in the OR group,with a statistically significant difference (x2 =4.555,P＜0.05).Operation time,volume of intraoperative blood loss,case with intraoperative blood transfusion,Ishak score of 1-3 and 4-6 scores,postoperative complications and duration of hospital stay were respectively (248±78)minutes,(292±229)mL,14,14,67,29,(12±7)days in the LR group and (221±78)minutes,(281± 194)mL,9,9,31,10,(13±6)days in the OR group,with no statistically significant difference between groups (t =1.843,0.282,x2 =0.473,0.473,1.431,t =0.075,P＞0.05).(2) Risk factors analysis affecting postoperative complication of HCC patients:39 of 121 patients had postoperative complications.Results of univariate analysis showed that retention 15-minute rate of indocyanine green (ICG R15),LSM,volume of intraoperative blood loss and Ishak score were risk factors affecting postoperative complication of HCC patients (x2 =7.161,32.490,7.725,2.863,P＜0.l).Results of multivariate analysis showed that LSM ＞ 15.0 kPa was an independent risk factor affecting postoperative complication of HCC patients [odds ratio (OR) =6.906,95％ confidence interval (CI):2.307-20.672,P＜0.05].(3) AUC of LSM and postoperative complication:when LSM of postoperative complication ＞ 17.5 kPa,sensitivity,specificity and AUC were respectively 64.1％,85.4％ and 0.749 (95％CI:0.662-0.824,P＜0.05).(4) Comparisons of intra-and post-operative situations,when LSM ≤ 17.5 kPa:duration of hospital stay was respectively (10±5) days in the LR group and (13±7) days in the OR group,with a statistically significant difference between groups (t--2.389,P＜0.05).(5) Comparisons of intra-and post-operative situations,when LSM ＞ 17.5 kPa:operation time,volume of intraoperative blood loss,cases with postoperative complications and hepatic dysfunction were respectively (277±76)minutes,(505±232)mL,21,17 in the LR group and (212-± 109) minutes,(328±250) mL,4,2 in the OR group,with statistically significant differences between groups (t=2.060,2.057,P＜0.05).(6) Comparisons of intra-and post-operative situations between patients with LSM ≤ 17.5 kPa and LSM ＞ 17.5 kPa in the LR group:operation time,volume of intraoperative blood loss,cases with postoperative complications and hepatic dysfunction and duration of hospital stay were respectively (236±76)minutes,(197± 153)mL,8,3,(10±5)days in the LR group and (277± 76)minutes,(505±232) mL,21,17,(16±9)days in the OR group,with statistically significant differences between groups (t=0.657,3.398,x2 =36.547,36.475,t=17.414,P＜0.05).Conclusion LSM is an independent risk factor affecting postoperative compfications after hepatectomy,when LSM ＞ 17.5 kPa,LR is associated with higher incidence of postoperative complications compared with OR.
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BACKGROUND: Loss of sacral slope has been shown to be an important anatomic basis for low back pain. The effect of sacral slope changes after lumbar fusion on pain relief remains unclear.OBJECTIVE: To analyze the variations of sacral slope and clinical significance at the early stage after posterior lumbar interbody fusion at L4-5.METHODS: Sixty patients with herniation at disc levels L4-5 and spinal stenosis (n=38) or lumbar spondylolisthesis at L4 (n=22) undergoing posterior lumbar interbody fusion were enrolled. All patients were followed up for 12-24 months to compare the sacral slop at baseline and postoperatively. The clinical outcomes were evaluated by MacNab criteria, and its correlation with age, sex and sacral slop variations was analyzed.RESULTS AND CONCLUSION: At 12-24 months postoperatively, the sacral slope in the two groups was significantly improved than that at baseline (P 0.05). The age, sex and sacral slop variations showed no significant effects on the early clinical outcomes (P > 0.05).These results suggest that posterior lumbar interbody fusion can markedly improve the sacral slope in patients with spinal stenosis and lumbar spondylolisthesis at early period. Furthermore, age, sex, and sacral slope variations all show no obvious effect on postoperative early functional recovery.
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Objective To establish an automatic warning program which accommodates to the test procedures in medical laboratory centerand and to put into operation.Methods Based on laboratory information management system (LIS),automatic warning program was established,which composed of maintenance of warning rules,feedback of vulnerabilities in rules,solutions of feedback targets and evaluation of ride-effectiveness.The results of performance were assessed after operation for six months in Guangzhou Kingmed Medical Laboratory Center.Results An automatic warning program containing 13 kinds of rule templates was successfully established.The multi-point warning program via asynchronous structure for six specialized testing procedures was realized.A total of 1 523 warning rules were included in the rule bank and 24 000 reports were verified on average each day.The average passing rate of reports was 70.2％ and the passing rate of single test was 83.9％.The approval time for reports was reduced by 10 to 40 minutes compared with that without using the automatic warning program.The efficiency for report approval was improved by 25 percent.Conclusion Automatic warning program may ensure the high quality of test reports,ease pressure on staff and improve work efficiency.
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Objective To introduce a improved method for the production of hemoglobin liquid by use of the hemoglobin electro‐phoresis alkaline .Methods First ,we used the pipette to absorb the settlement of red blood cells from a batch of EDTA anticoagula‐ted whole blood specimens ,then dropped them into the 0 .9% saline washed human erythrocytes .With the help of the pipette nozzle we pipet from the liquid surface to bottom repeatedly ,made the red cells suspended in the liquid evenly .The samples should be cen‐trifuged and the red blood cells fully deposited at the bottom ,then poured the supernatant after centrifugation to remove the impuri‐ties in plasma and leave the allowance of red blood cells .We add distilled water or hemolysin to lysis RBC .Hands up test tubes rack using wrist gently back and forth several times until the hemolysis was clear and transparent .Results Compared the results of the modified method and the traditional method ,then the two results compared with the results of HPLC recommended by international association of thalassemia method .Compared the results of three screening methods with that of the thalassemia gene identification method .So we could objectively evaluate the reliability of the test .Conclusion The result of the improved method are same to the electrophoretogram by SOP operation ,it will be more efficient and reduce the cost of reagent .The whole process of preparing hemo‐globin solution doesn′t contact with any chemical reagent .So there will be no pollution to the environment ,and it also reduces the harmful of toxic reagent to the human body .
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Objective The aim of this paper is to describe the designing and implementation of a web-based plasma glucose measurement quality monitoring system to assess the analytical quality of plasma glucose measurements in multicenter population study and provide evidence for the future studies.Methods In the chronic non-communicable disease and related factor surveillance in China,a web based quality monitoring system for plasma glucose measurement was established to conduct evaluation on plasma glucose monitoring quality and effectiveness in 302 surveillance centers,including quality control data entry,transmission and feedback.Results The majority of the surveillance centers met the quality requirements and passed the evaluation of reproducibility and precision of plasma glucose measurement,only a few centers required intensive training and re-assessment.Conclusion In order to ensure the completeness and reliability of plasma glucose measurement in the surveillance centers,the establishment of web-based plasma glucose measurement quality control system can facilitate the identification of the qualified surveillance centers and evaluation of plasma glucose measurement quality in different regions.Communication and training are important in ensuring plasma glucose measurement quality.It is necessary to further improve this web-based plasma glucose measurement quality monitoring system in the future to reduce the method specific plasma glucose measurement bias.
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Objective To verify result consistency of the improved examination method and the standard operation method with the erythrocyte osmotic fragility test (OFT).Methods The samples and reagents were reduced half volume and used different testing equipment to evaluate methods for OFT.Selected 100 samples that the brittleness were increased and de-creased (50 samples positive and negative respectively),used a kind of improved examination method and traditional test method to evaluate the consistency.Results The detection result of improved examination method and the detection results of the manufacturer standard method were consistent (t=1.660 8,P >0.05).So,there was no significant difference of con-trast between two groups of data.Conclusion Improved mothed OFT alternatives to traditional OFTscreening method could be faster,more objectively the results of clinical service,and could effectively reduce reagent and manpower cost,improve the efficiency of work.Therefore,this method could be used to groups detection and lack of equipment for the primary care of hospital screening thalassemia desease method is preferred.
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Objective To compare the difference of the self-concept and self-esteem between the common and sub-orphan children,and explore the correlation of the self-concept and self-esteem.It can provide objective basis for appropriate psychological intervention.Methods Across-sectional survey,185 sub-orphan children of a sub-orphan charity school and 167 common children were investigated,Children's Self-concept Scale(PHCSS) and Children 's Self-esteem scale (CSES) were used to measure the self-concept and self-esteem.Results (1) There was no significant difference on total score of PHCSS between two children groups ((53.30± 13.34) vs (50.83± 11.53),t=1.86,P=0.06),but the score of intelligence and the situation in schools,appearance and properties,gregarious in sub-orphan children was significantly higher than that of common children,respectively((10.64±3.45) vs (9.23±3.47);(7.05±3.19) vs (6.31±2.73);(8.30±2.43) vs (7.72±1.86),P＜0.05).(2) There was no significant difference on total score of CSES between two children groups(P＞0.05),but the score of the sports and achievement of CSES in sub-orphan children was significantly less than that of common children,respectively (P＜ 0.05).(3) There was significant correlation between self-concept and self-esteem in sub-orphan children (P＜0.05).Conclusion There are some psychological problems in sub-orphan children and need to implement appropriate psychological intervention.
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Objective To identify two suspected Legionella pneumophila (L.pneumophila) strains isolated from environmental water and air conditioning cooling water systems in Guangzhou city.Methods The two strains were identified by their cultural characteristics,biochemical test,Legionella-specific primer PCR identification,PCR-enzymatic digestion analysis,16S rRNA,mip and rpoB gene sequencing analysis.Results The two suspected L.pneumophila isolates were identified as gram-negative bacillus appeared as white colonies on BCYEα-agar after incubation for 48 hours at 36℃.Both isolates were positive for oxidase,gelatinase and hydrolysis of hippurate,and negative for urease activity and nitrate reduction.Their phenotypic characteristics were similar to those of L.pneumophila strains.Results of PCR identification by using Legionella-specific primer were positive.Enzymatic digestion analysis showed that the 226 bp PCR products of two isolates were not digested by Taa Ⅰ.The two strains were classified as Legionella busanensis as indicated by gene sequencing analysis of 16S rRNA,mip and rpoB gene.Conclusion Two L.busanensis strains were first isolated from environmental and air conditioning cooling water systems in China.Due to their biochemical characteristics,L.busanensis strains were commonly misidentified as L.pneumophila,but could be effectively identified by PCR-enzymatic digestion analysis and multiple genes identification.
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Objective To analyze the articles and citation published in the Chinese Journal of Internal Medicine from 2008 to 2010,in order to investigate the influence factors of impact factor (IF).Methods All articles published in the Chinese Journal of Internal Medicine covered by Chinese Medical Citation Index(CMCI) from 2008 to 2010 were searched and downloaded.Some article related attributions were manual added and their influences to IF were analyzed.Results A total of 1164 academic papers were published in the journal in 3 years,with 9.95 references per paper.The total citation was 1029 times,with 0.93 time per paper and 0.31 time per page.Among them,736 articles were not cited,accounting for 63.2％.Original articles,pure clinical articles had good citation output.For fund supporting,the citation of articles without fund was higher than those with fund.The articles on hematology,cardiology and gastroenterology accounted the most,while ICU,emergency and nephrology were the least internal medicine reported specialties.Although there exists citation difference among different subjects,for considering the absolute values,neurology/psychiatry (0.73 time per paper),cardiology (0.65 time per paper) and gastroenterology (0.54 time per paper) had better citation output,while hematology,basic research and rheumatology had no good performance to IF.Conclusion We should further strengthen acquisition and dissemination of excellent articles,reduce the number of non-cited paper,expand periodical visibility,and provide a quick and convenient way of literature reading.
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Objective To evaluate the academic level of Chinese Journal of Internal Medicine by analyzing its citation status by using bibliometrics method.Methods The distribution of articles published in Chinese Journal of Internal Medicine from January,2005 to December,2011 indexed by Chinese Science Citation Database (CSCD) was analyzed.Results A total of 2809 articles were published in Chinese Journal of Internal Medicine between January,2005 and December,2011.Among them,832 (29.62％) articles were cited for totally 1993 times.There were 14 authors whose total citation number in 2005-2011 was ≥ 10 times.Authors of the cited articles came from 25 provinces,autonomous regions and municipalities.The regions from where the articles had the highest citation were Beijing (341 articles),Shanghai (87 articles),Guangdong (64 articles),Jiangsu (45 articles) and Zhejiang (43 articles).The medical institutions with the highest citation were Peking Union Medical College Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences (205 times),Peking University People's Hospital (77 times),and Chinese PLA General Hospital (76 times).Conclusions Quite a few high level academic papers had been published in Chinese Journal of Internal Medicine in recent years.Chinese Journal of Internal Medicine plays a good role in enhancing academic exchange.
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ObjectiveTo investigate the genotype of a case with abnormal hemoglobin combined with hereditary persistence of fetal hemoglobin (HPFH).Methods Male patient,26 years old,were suspected abnormal hemoglobin combined with HPFH after receiving medical examination including hematology exmination,hemoglobin electrophoresis,erythrocyte osmotic fragility analysis in Guangzhou Kingmed Diagnostics in September 2010.Routine examination of anemia and hemoglobin electrophoresis at alkaine pH on agarose gels were applied to analyze the phenotype.Direct sequencing of the complete HBB gene was utilized to identify the hemoglobin variant.Multiplex ligation-dependent probe amplification (MLPA) assay was used to identify the presence of β-globin gene cluster deletion.Gap polymerase chain reaction (gap-PCR) was used to amplify the HBB gene fragment across the breakpoint,and the deletion breakpoint was characterized by direct sequencing the gap-PCR product and comparing the sequencing result with the reference sequence NC_000011.9.ResultsBy direct sequencing of the complete HBB gene,the patient in this study was found to carry a hemoglobin Ta-Li (HBB:c.250G ＞ T) mutation.By combining use of MLPA and gap-PCR with gene sequencing,we found that it had a gross deletion in the β-globin gene cluster,the deletion region was NC_000011.9:g.5222878_5250288del.Therefore,the genotype of this subject was SEA-HPFH combined with abnormal hemoglobin Ta-li.ConclusionCombining application of MLPA and gap-PCR with gene sequencing can help to make sure the genotype.
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ObjectiveTo investigate different personality traits and psychological interventions'effect on the patients' anxiety in fiberbronchoscope examination.MethodsThe eysenck personality questionnaire(EPQ)scale and Zung self-rating anxiety scale(SAS) were used to assess the patients.The patients were randomly divided into experimental and control groups,the experimental group,respectively,the implementation of cognitive therapy and relaxation treatment of psychological intervention,psychological evaluation was investigated again before fiber bronchoscopy.ResultsThe scale showed that it had significant difference(P＜0.05 ) between before and after the psychological intervention( before intervention:55.8 ± 1.50,54.9 ± 1.62,57.84 ± 2.13 ; after intervention:46.2 ± 1.38,45.3 ± 1.47,59.26 ± 2.41 ).The patients'personality trait was correlated with their anxiety(P＜0.01 ).ConclusionsThe psychological intervention can be effective in reducing patients'anxiety,and it can help patients take the initiative to meet the inspection,improve the success rate of inspection.And different personality traits can effect on patients' anxiety level.
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OBJECTIVE@#To analyze the clinical, familial and hereditary features of myotonic dystrophy to improve the knowledge and provide molecule evidence for gene diagnosis and prenatal diagnosis of myotonic dystrophy or dystrophia myotonia (DM) families.@*METHODS@#Clinical data of 2 DM families were collected based on the probands. The number of trinucleotide CTG repeat in the 3' untranslated region of myotonic dystrophy protein kinase (DMPK) gene on chromosome 19 was determined by DNA sequence and repeat fragment.@*RESULTS@#Except for 1 subclinical patient, another 5 patients progressed slowly with the features of myotonic muscular weakness and atrophy. One patient had hatchet face, 1 had cataract and diabetes mellitus, and the other 3 were bald. Electromyologram showed 3 patients had myotonic discharge and myopathic abnormalities. The number of trinucleotide CTG repeat in the 3' untranslated region of DMPK gene of 5 patients exceeded 50.@*CONCLUSION@#DM can be anticipated. Gene analysis can verify the disease and identify subclinical patients. It helps to prevent the DM births by hereditary consultation performing prenatal diagnosis.
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Adolescente , Adulto , Feminino , Humanos , Masculino , Distrofia Miotônica , Diagnóstico , Genética , Miotonina Proteína Quinase , Linhagem , Reação em Cadeia da Polimerase , Métodos , Proteínas Serina-Treonina Quinases , Genética , Repetições de TrinucleotídeosRESUMO
Objective To identify one runny mucoid-like Gram-negative bacteria with pink pigment isolated from clinical pus sample. Methods The pus sample was aseptically extracted from a deep lesions of one patient, then stored in Amies medium at room temperature for transportation. One sheep blood plate and one chocolate plate were used to detect the possible pathogens from the specimens. After inoculation, the plates were placed in a humidified incubator with 5% CO2 at 35 ℃. To identify the obtained isolates, we used the commercial Vitek2 and API systems, combining some traditional morphological examination and classical biochemical and physiological characteristics. For pure cultures, the cellular fatty acids were extracted, methylated, and determined by gas chromatography method. The 16S rRNA gene was amplified and sequenced by a commercial broad-spectrum PCR primers. The phylogenetic tree based on 16S rRNA gene was constructed by Mega 4.1 software using the neighbour-joining methods with 1 000 bootstrap replications. Results One runny mucoid-like Gram-negative bacterium, named K8756, was isolated both on sheep blood and chocolate plates after 72 h incubation. The API 20NE profile was 1245045 after a 3-day culture, which would be identified as Ochrobactrum anthropi with a good confidence of 98% probability. It was identified as Ralstonia pickettii and Bordetella bronchiseptica by VITEK 2 GN kits. However, further comparative 16S rRNA gene sequences showed that strain K8756 was closely related to the valid published Roseomonas mucosa MDA 5527 with 100% identity. Colonial morphologic features, phenotypic characteristics and major cellular fatty acid composition were also with high similarity to Roseomonas mucosa. Conclusions Strain K8756( = GIMCC 1.0030 ) is identified as Roseomonas mucosa by the polyphasic phenotypic and genotypic characteristics. The comparative analysis based on 16S rRNA gene sequences is a useful method for identifying the problematic and newly named bacteria.
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Objective Ascending aortic dissection(AAD),for which the pathogenesis remains unknown,is life-threatening.Matrix metalloproteinase-9(MMP-9)and the pathological changes of vascular smooth muscle cells(VSMCs)have been reported to have roles the pathogenesis.The study examined the expression of matrix metalloproteinase-9(MMP-9)and the pathological changes of,VSMCs in patients with AAD.Methods AAD samples were taken from 35 patients(disease group)in acute phase during aortic replacement operation for AAD and control samples were corresponding part of ascending aorta(control group,n=21)collected from the donor hearts for transplantation.Transmission electron microscepe,hematoxylin-eosin(H-E)staining.Mallory staining were used for observing the pathological changes of VSMCs and matrix in the affected aortic wall.The immunohistochemicai staining of MMP-9 was carried out in both groups and semi-quantified by staining intensity analysis.The affected patients were further grouped according to the diameter of dissected aorta as with a AAD of <55 mm or with a AAD of≥55 mm.The associations of clinical factors,such as smoking status,hypertensive disease and aneurysm diameter,with the expression of MMP-9 were analyzed.Results Increased synthetic function of VSMCs with decreased density,disrupted elastic fibers and fibrosis in the dissected aortic wall were observed in the disease group,but not in the control group.MMP-9 was scarcely expressed in the aortic wall of the patients in the control group,though it was notably expressed in the VSMCs of disease group.Both subgroups presented more MMP-9 than the control group(both P<0.001).In the disease group,sub-group with a AAD diameter of ≥55 mm presented more MMP-9 than that with a diameter of <55 mm(P<0.05).MMP-9 expression was positively correlated with a history of hypertension(P<0.01)or a great aneurysm diameter(P<0.05).MMP-9 expression was not associated with age,smoking status or other clinical factors.Conclusion Increased secretion of VSMCs and the expression of MMP-9 induced by elevated blood pressure may lead to the destruction of matrix proteins.The resulting fibrosis of the aortic wall would decrease the tensile strength of the wall.When the fibrotic aortic wall dilated further,the increased expression of MMP-9 would aggravate the damage to the wall.It can be speculated that acute AAD would occur as a result of partial tearing of the aortic intima.
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Objective To observe influence of atorvastatin to high sensitive C-reactlve protein in the new on-set type 2 diabetes of normal blood lipid with macrovascular disease. Methods 96 cases with the new onset type 2 diabetes of normal blood lipid with macrovascu]ar disease were randomly divided into two groups,the treatment group contains 49 cases who were given atorvastatin 10rag for 12 weeks,the control group contains 47 cases who were given placebo for 12 weeks. Two groups were underwent the following test,fasting plasma glucose(FBG) ,post-OGTT 2 hour plasma glucose(PPG) ,glycosy-lated hemoglobin(HbAic) ,total triglyceride(TG) ,total cholesterol(TC) ,low density lipoprotein cholesterol(LDL-C) ,high sensitive C-reactive protein(hs-CRP). Results High sensitive C-reactive pro-tein(hs-CRP) in treatment group is significantly lower than control group[(2.13±1.38) mg/L and (4.04±3.14) mg/L,P < 0.05]. Conclusion Atorvastatin can significantly decease the level of high sensitive C-reactive protein (hs-CRP) to the new onset type 2 diabetes of normal blood lipid with macrovascular disease.
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BACKGROUND: Compression occurs in several horizontal spinal cords of patients with multilevel cervical spondylotic myelopathy (CSM), especially compression is attacked on both ends of spinal cord. Therefore, there are so many choices of approach and way for operation. However, which approach and way have good effects and few complications is still controversial up to now.OBJECTIVE: To observe the therapeutic effect of anterior multilevel decompression and internal fixation on multilevel CSM and compare with posterior mono-open-door vertebral canal expanding laminoplasty.DESIGN: Contrast analysis.SETTING: Department of Orthopaedics, Xiangya Hospital of South China University; Department of Orthopaedics, People's Hospital of Liuzhou.PARTICIPANTS: A total of 68 patients with multilevel CSM were selected from the Department of Orthopaedics, Xiangya Hospital of South China University from January 2000 to June 2005. All patients were divided into anterior approach surgery group (n =33) and posterior approach surgery group (n =35). Baseline data between the two groups were comparable.METHODS:①Anterior approach surgery group: All 33 patients received bone-transplanting and internal fixation through cervical spine. Among them, auto-iliac bone-graft was transplanted into 17 cases, Cage auto-bone graft combining with allogenic bone was transplanted into 11 cases, and titan-net and auto-bone combining with allogenic bone was transplanted into 5 cases. In addition, long segments were dealt with internal fixation of anterior cervical spine locking plate (CSLP). Among them, 12 cases used Orion plate, 13 cased used Zephir palte, and 8 cases used Codman plate. ②Posterior approach surgery group: Fifteen patients received total laminectomy for decompression and other twenty patients received mono-open-door vertebral canal expanding laminoplasty. After laminoplasty, all patients received negative pressure and neck support fixation for three months.MAIN OUTCOME MEASURES: ①Scores were measured based on JOA evaluating system before and after laminoplasty to calculate recovery rate. The scores of JOA ranged from 0 to 17. The higher the scores were, the milder the spinal cord damage was. ② Magnetic resonance image (MRI) was used to measure and calculate the sagittal diameter of dural sac.RESULTS: A total of 68 patients were involved in the final analysis. ①Mean operative time and bleeding volume were respectively shorter and less in the posterior approach surgery group than those in the anterior approach surgery group (P＜0.05). ②Recovery rates were higher in the anterior approach surgery group than those in the posterior approach surgery group [(58.28±7.16)%, (42.71±5.85)%; (45.64±6.56)%, (37.65±5.75)%; P＜0.05].③Follow up lasted for more than 6 months. Fusion rate in the anterior approach surgery group was 100%, and mean fusion time was 4.6 months. Mobilization and breakage of plate and screw were not observed during the laminectomy.CONCLUSION: The posterior approach surgery is simple and spends a short-term duration, but the effect of posterior approach surgery is inferior to anterior approach decompression.
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AIM:It is suggested that the peptidergic nerves containing substance P(SP),calcitonin gene-related peptide(CGRP),vasoactive intestinal peptide(VIP),neuropeptide Y(NPY) and tyrosine hydroxylase(TOH) co-exist in bone tissues and distribute in the active bone metabolism area,indicating these peptidergic nerves are closely related with bone growth and development. In this study,the expression of neuropeptides in tibial callus of rats after brain injury was observed. METHODS:The experiment was conducted in the Experimental Animal Center of Guangxi Medical University from February to May 2007. ①130 male Wistar rats of 3-4 months old and 450-550 g were randomly divided into fracture group(n =60),brain injury plus fracture group(n =60) and control group(n =10). ②The right parietal bone of anesthetized rats was exposed,and bone window of 5 mm was opened 2 mm near median line,then moderate brain injury was made by sap pressure,and the rat models of tibial fracture were established. The fracture group was only subjected to cranial bone window,and the control group was not given any treatment. ③The distribution of neuropeptide in tibia and callus succession as well as fracture healing were observed by HE and immunohistochemical staining on postoperatively days 3,7,14,21,28,and 35 days. The callus area in brain injury plus fracture group and fracture group was detected by computed radiography(CR) at 14,21 and 28 days after operation. RESULTS:All 130 rats were involved in the result analysis. ①At early stage after brain injury,there were a quantity of fibrous callus and cartilaginous callus formation in brain injury and fracture group and many neuropeptides immunoreactive nerve fibers in callus were found. Strong immunoreactivites of CGRP,SP,VIP,NPY,TOH occurred to osteogenitor cells and chondroblast,which proliferated in thickened endothecium. ②In brain injury and fracture group on day 14,the chondrocyte group was enlarged and subperiosteum chondrocyte layer was thickened;on day 21,bone trabecula was significantly thickened,and cartilage islands were increased;on day 28,there were still quantity of fibrous callus and cartilaginous callus,and sparse woven bones surrounding chondrocyte groups. In fracture group,periosteal reaction was slight,and fibrous callus was few;osteogenesis in bone and cartilage occurred,but mainly in bone. Moreover,the fracture healing was remarkably later than brain injury and fracture group. ③Callus area in brain injury and fracture group was larger than that in fracture group on days 14 and 21(P
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Objective To develop a selective isolation media which has a high isolation ratio for Legionella.Methods We compared the growth of Legionella pneumonia on BCYE? plate (with DGVP), BCYE?(with GVPC) and BCYE? (with CCCV) by colony count and compared with BCYE? plate. The comparison of isolation ratio of Legionella pneumonia from air-conditions cooling water with 3 kinds of BCYE? plate containing different anti-reagents was performed.Results The results of colony count on BCYE? plate (with DGVP) and BCYE?(with GVPC) was identical with that on BCYE? plate at same concentration. But the result of colony count on BCYE? plate (with CCCV) was half of the former 2 kinds of plate. 5 strains of Legionella pneumonia isolated from 9 central air-condition cooling water were used by BCYE? plate (with DGVP) and BCYE? (with GVPC), while only 2 strains of Legionella pneumonia were isolated by BCYE? plate (with CCCV). Legionella pneumonia wasn′t detected by BCYE? plate.Conclusion BCYE? plate with antibiotics system of CCCV showed obvious suppression to Legionella pneumonia, and so that there was a low isolation ratio to Legionella pneumonia. But BCYE? plate with antibiotics system of DGVP and GVPC had a few suppression and showed a high isolatio ratio for Legionella pneumonia. Moreover, BCYE? plate with antibiotics system of DGVP and GVPC can effectively inhibit non-Legionella and increase isolation ratio of Legionella. They should be the first selection media for Legionella from environment and clinical samples.