Showing papers by "XinHua Hospital published in 2002"

Low lumbar spinal fractures: management options.

Abstract: Fifty-four patients with low lumbar spinal fractures were retrospectively reviewed. Of these, there were 25 compression fractures, 21 burst fractures, three flexion-distraction fractures and five fracture-dislocations. Three patients had a complete neurological lesion, 17 sustained an incomplete neurological injury, and 34 were neurologically intact. Twenty-six patients were treated non-operatively and 28 underwent surgery. All patients were followed up for l–12 years. Forty-three patients (79.6%) have returned to their former employment or activity level. Four patients had experienced significant improvement but suffered from some limitation of activity. Five patients were unable to stand up and walk without support although they had some degree of improvement. Two remained completely paralyzed. There were no differences in neurologic function between patients treated non-operatively or operatively (P>0.05). The patients treated operatively had significantly less pain compared to the patients treated non-operatively (P<0.01). Because of the unique anatomy and biomechanics, fractures of the low lumbar spine are different from those in the remaining regions of spine. Most compression fractures are stable, and therefore conservative management is indicated. Surgery should be performed in those with burst fractures or flexion-distraction fractures, with severe spinal stenosis or kyphotic deformity, and fracture-dislocation.

Region-specific ontogeny of α-2,6-sialyltransferase during normal and cortisone-induced maturation in mouse intestine

Abstract: Regional differences in the ontogeny of mouse intestinal α-2,6-sialyltransferase activities (α-2,6-ST) and the influence of cortisone acetate (CA) on this expression were determined. High ST activi...

The trends of changes in children's blood lead levels since the introduction of lead free gasoline in Shanghai.

Abstract: OBJECTIVE To describe trends of changes in blood lead levels in children aged 1 - 6 years during the time period before and after introducing lead free gasoline in Shanghai 1997 and 1999. METHODS Blood lead levels of 1 969 children aged 1 - 6 years were determined by a sampling survey in five districts of Shanghai in August and September, 1997. Blood lead levels of the same population were re-determined by the same method from April to June in 1998 and from August to September in 1999. Filter paper blood lead test was carried out monthly using the filter paper blood lead proficiency testing program of Centers for Disease Control in the United States. The results from blood lead samples were under acceptable ranges during the study. RESULTS The geometric means of blood lead levels were 83 microgram/L in 1997, 80 microgram/L in 1998 and 76 microgram/L in 1999, respectively. The prevalence rates of childhood lead poisoning (blood lead level was equal or more than 100 microgram/L) were 37.8% in 1997, 25.7% in 1998 and 24.8% in 1999. The amounts of decrease on average blood lead levels in the five districts between 1997 and 1999 were 10 microgram/L, 11 microgram/L, 6 microgram/L, 4 microgram/L and 2 microgram/L, respectively. CONCLUSION Lead poisoning is a preventable disease. The average levels of lead in young children in Shanghai decreased significantly after the introduction of lead free gasoline to Shanghai. Lead emissions from vehicles running on leaded gasoline was one of the important contributors to increase the children's blood lead levels in Shanghai. Lead poisoning is not evenly distributed among children in Shanghai, resulting in the different levels of decline.

Influence of hepatic arterial blockage on blood perfusion and VEGF, MMP-1 expression of implanted liver cancer in rats.

Abstract: Influence of hepatic arterial blockage on blood perfusion and VEGF, MMP-1 expression of implanted liver cancer in rats

Effect of shengmai injection on hemodynamics in patients with dilated cardiomyopathy

Abstract: Objective: To observe the effects of Shengmai Injection (SMI) on hemodynamics in patients with dilated cardiomyopathy (DCM), and to explore the clinical effect of SMI in treating patients of DCM with heart failure. Methods: One hundred patients were divided into two groups. In the 50 cases of the treated group, 10 cases with heart function of Ⅱ degree, 35 of Ⅲ degree and 5 of Ⅳ degree. The corresponding number of cases in the 50 patients of the control group were 10, 36 and 4. Conventional treatment was given to both groups, and SMI was administered to the treated group additionally. The therapeutic effect and the indexes of heart function before and after treatment were determined and compared. Results: In the treated group, treatment showed markedly effective in 22 cases and effective in 20, the total effective rate being 84%, while in the control group, markedly effective in 14 and effective in 16, the total effective rate being 60%, the comparison between the two groups showed significant difference (χ 2=7 14,P0 01). In the treated group, cardiac output, stroke volume (SV), cardiac index, eject fraction (EF), lefe ventricular minor axis shortened rate, ventricular wall thickened rate were all increased after treatment and system vascular resistance (SVR) decreased significantly (P0 05), while in the control group, insignificant change was found in the above mentioned parameters after treatment (P0 05). Comparison between the two groups after treatment showed that EF and SV were obviously higher and SVR obviously lower in the treated group than those in the control group. Conclusion: SMI could markedly improve the heart function of patients with DCM. The effect of conventional treatment would be enhanced in combination therapy with SMI.

[Sleep time of children from 1 month to 5 years of age in Shanghai, an epidemiological study].

Abstract: Objective To assess the age specific sleep time among children 1 month to 5 years of age in Shanghai, China, and to identify the related factors. Methods A questionnaire survey was conducted among the parents of 3 266 children 1 month to 5 years of age, randomly selected in five urban districts of Shanghai in August and September of 1999 and 2000, with a response rate of 97.83%. Results The total sleep time among children less than 48 months of age in Shanghai was less than that among children the same age in Western countries. The factors related to children′s inadequacy of total time inoluded parental insufficient sleep time, children′s difficult temperament parental presence at sleep onset of children, and cosleeping. Conclusions The total sleep time among children at tender age in Shanghai is on the low side. The main influencing factor of insufficiency of sleep time among children is the family environmental factor, especially parental improper response to children′s sleep behaviors.

[Expression of activins, follistatin mRNA in the development of hepatic fibrosis].

Abstract: OBJECTIVE To examine the expression changes of activin beta A, beta C, beta E and follistatin mRNA in the development of rat hepatic fibrosis induced by carbon tetrachloride (CCl(4)). METHODS Hepatic fibrosis was induced in rats by subcutaneous injections of 40% carbon tetrachloride oily solution for a period of 1 to 7 weeks. After carbon tetrachloride injection of 1, 2, 3, 4, 5, 6, and 7 weeks, the 6-12 rats were killed every time. The kinetics of activin beta A, beta C, beta E and follistatin mRNA expression were assessed by the semi-quantity RT-PCR. RESULTS Activin beta A, beta C, beta E and follistatin mRNA could be detected in normal rat livers. After CCl(4) injection for 2 or 3 weeks, beta A mRNA was transiently decreased and became undetectable, then increased gradually. After CCl injection for 6 and 7 weeks, beta A mRNA level was significantly higher than controls (P<0.01). beta C mRNA could be detected after CCl(4) injection for 1 to 4 weeks and was significantly increased after 5 weeks over controls (P<0.05). beta E mRNA could not be detected after CCl(4) injection for 1 to 5 weeks, but significantly increased after CCl(4) injection for 6 or 7 weeks compared with controls (P<0.01). Except for normal rat liver, no follistatin mRNA was detected in rats after CCl(4) injection. CONCLUSIONS Activins and follistatin have different expression changes in the development of hepatic fibrosis and the imbalance of activins and follistatin expression may involve in the formation of hepatic fibrosis.

Telomerase activity and its correlation with the proliferative potential of bone marrow in aplastic anemia in children.

Abstract: Objective: To explore telomerase activity and its association with the proliferative potential of hematopoietic stem cells in bone marrow (BM) in patients with aplastic anemia (AA).

Factors related to acute upper gastrointestinal bleeding after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

Abstract: BACKGROUND & OBJECTIVE Acute upper gastrointestinal bleeding (UGIB) often occurs after transcatheter arterial chemoembolization (TACE) in the patients with hepatocellular carcinoma (HCC). The authors studied the factors associated with UGIB for better prevention and management of the complication. METHODS Epirubicin, cisplatin, mitomycin, 5-fluorouracil, lipidol and/or gelfoam were infused via catheters inserted in ciliac artery, common hepatic artery, arteria hepatica propria, or left or right hepatic artery by Seidinger method in 208 cases of advanced HCC confirmed by image techniques, alpha-fetoprotein (AFP) and/or pathology. Factors related to UGIB (vomiting of blood and/or melena, or positive fecal occult blood) were analyzed with reference to endoscopy, biochemical parameters of liver function, selection of blood vessels, and the amount of drugs. RESULTS Of 208 patients, 31 cases were complicated with UGIB. Acute gastric mucosal lesion was confirmed in 18 cases; acute ulcer in 3 cases; Mallory-Weiss syndrome in 3 cases; and esophageal varices bleeding in 2 cases. Positive correlation was found between B grade of Child-Pugh hepatic functional reserve and bleeding (r = 0.59, P < 0.005). The incidence of UGIB in patients in whom drugs were infused via ciliac artery (7/18, 38.9%); or common hepatic artery (18/38, 47.4%) was significantly higher than in those via arteria hepatica propria, left, or right hepatic artery (5/146, 3.4%; P < 0.005). Patients with larger amount of chemotherapy drug and embolization agent had higher bleeding rate. CONCLUSION Many factors may be associated with UGIB after TACE in patients with HCC, such as higher scores of hepatic functional reserve in Child-Pugh grading, selection of blood vessels, and amount of drugs. In order to reduce the incidence of UGIB, these factors should be necessarily considered in improvement of TACE procedure, in inspection and management after TACE.

Mechanism of thoracolumbar burst fractures: a biomechanical study.

Abstract: Objective To investigate the mechanism associated with thoracolumbar burst fractures. Methods Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional finite element model of the spinal motion segment. Results Stress concentration was noted at the pedicle and posterosuperior part of the vertebral body near the pedicle. Conclusion Stress concentration of the spine may be implicated in the biomechanical mechanism underlying thoracolumbar burst fractures.

Surgical treatment of tetralogy of Fallot with absent pulmonary valve

Abstract: Objective To introduce the technique of surgical treatment of tetralogy of Fallot with absent pulmonary valve(TOF/APV) Methods From January 1985 to September 2000, 13 patients with TOF/APV underwent surgical correction at our hospital Results The post operative mortality was 7 7% (1/13) with no later death Surgical complications included low cardiac output in 3 cases, pericardial effusion in 1 case Eight patients suffered from pulmonary regurgitation (5 mild, 2 moderate, 1 severe with congestive heart failure) during the follow up of 1-3 years after surgery Conclusions We recommend that older children can be treated electively,while infants should be treated early The technique of partial resecting and plicating of dilated pulmonary artery and pulmonary valve implantation may improve outcome in patients with airway compression

Prognostic factors influencing survival in patients with large hepatocellular carcinoma receiving combined transcatheter arterial chemoembolization and radiotherapy

Abstract: OBJECTIVE To observe the long-term effects of combined transcatheter arterial chemoembolization (TACE) and radiotherapy for patients with large hepatocellular carcinoma (HCC) and to analyze the prognostic factors METHODS A total of 107 patients with large unresectable HCC (the largest diameter of tumor ranged from 5 to 18 cm) were treated with TACE followed by external-beam irradiation Acute effects and survival rates were observed The Cox proportional hazards model was used to analyze the prognostic factors RESULTS An objective response was achieved in 486% of the cases The cumulative survival rates at 1, 3, and 5 years were 594%, 284%, and 158%, respectively The tumor number and irradiation dose were the independent prognostic factors The cumulative survival rates of the patients with a solitary lesion (758%, 439%, and 268% at 1, 3, and 5 years, respectively) were significantly higher than those with multiple lesions (313%, and 50% at 1 and 3 years, respectively, P=00005) The survival rates of the patients received irradiation above 40 Gy (958%, 747%, and 374% at 1, 3, and 5 years, respectively) were significantly higher than those received 20~40 Gy (609%, 207%, and 103%, respectively) and those received radiation lower than 20 Gy (267%, 71%, and 71%, respectively, P=00001) CONCLUSIONS Combined TACE with radiotherapy is a promising treatment for large unresectable HCC The number of tumor is the most important clinical prognostic factor Delivering the highest irradiation dose within the tolerance of the liver is the key to improve the long-term effect

Diagnosis, treatment and gene detection in 769 cases with hyperphenylalaninemia

Abstract: Objective Hyperphenylalaninemia (HPA) is a genetic disease with the higher blood phenylalanine (Phe) level caused by the phenylalanine hydroxylase deficiency or the lower enzyme activity. Phenylketonuria (PKU) is the most common type of HPA. In this paper, the authors reviewed the clinical diagnosis, treatment and gene mutation detection of HPA in order to set up a preventive and therapeutic method for the disease. Method Seven hundred and sixty-nine subjects (454 males and 315 females, aged 0.8—27 years) with HPA from 28 provinces of China were enrolled in this study. Among them, 95 patients were diagnosed by the neonatal screening, 50 diagnosed by the high risk screening, the other 624 patients were diagnosed later. The family histories of all patients were investigated. The Phe concentration was determined with Guthrie bacterial inhibition assay and fluorescence method. The tetrahydrobiopterin deficiency (BH4D) was examined with the urinay pterin analysis and BH4 loading test. PKU patients were treated with the low or free Phe formula. The patients with BH4D were treated with BH4 and neurotransmitter precursors. The effects of the clinical treatment in patients with various HPA types were evaluated. The PKU gene was detected for mutations in 100 PKU patients. Prenatal diagnosis was carried out for 23 families with high risk PKU by using denaturing gradient gel electrophoresis (DGGE) and STR linkage analysis. Result (1) Of 769 patients 730 were diagnosed as having classic PKU, 27 patients as mild HPA and, 12 patients as BH4D whose urinary percentage of biopterin was (1.74±2.6) %, which was below the normal range. (2) Three hundred and thirty-eight PKU cases were treated with low or no phenylalanine milk. Of 95 patients, 71.6% of patients was diagnosed by neontal screening and 54.7% of 243 patients diagnosed later and the Phe could be better controlled with the treatment. (3) The intelligence quotient (IQ) evaluation was performed in 112 treated patients. The IQ of 55 patients diagnosed and treated after the neonatal screening was (78±22) score, IQ of 57 patients diagnosed later was (62±18) score. The IQ scores of these two groups were significantly different(P<0.001). IQ score of five BH4D patients was 70—80 after the treatment with combination of BH4 and neurotransmitter precursors. (4) Seventy-two patients went to school and 66.7% of them showed a middle or higher study score. (5) Five mutations, Arg111Ter, Arg241Cys, Arg243Glu, IVS6nt-1 and Arg252Gln, as well as a polymorphism of Val245Val were found in 100 PKU cases. (6)Prenatal diagnosis was performed for 23 families with high risk PKU, three fetuses were found to have PKU, and 20 fetuses were normal or heterozygotes which was confirmed by the neonatal screening for PKU after birth. Conclusion Both prenatal diagnosis and early diagnosis are effective methods for prevention and treatment of PKU. The early treatment and restriction of Phe level can minimize the mental retardation for HPA patients. Key words: Phenylketonurias; Neonatal screening; Biopterin; Genes; Mutation

Double Stranded RNA (RNA inteference RNAi) in Different Creatures

Abstract: Double stranded RNA could degrade mRNA of target gene. It is a useful way for studying gene function. It is used widely in different creatures,such as Arabidopsis thaliana, Caenorhabditis elegans, Drosophila melanogaster, Zebrafish, Mouse. This review is mainly related to the application of dsRNA in recent years.

Interventional treatment of intracranial aneurysm in children

Abstract: Objective:To evaluate the effect of embolization therapy with Guglielmi detachable coils(GDC)in intracranial aneurysm in pediatric patients.Methods:Three patients with intracranial aneurysm were reported,there were one male and two female cases.All of them were complicated with acute subarachnoid hemorrhage (SAH).The symptoms and signs were nonspecific and the diagnosis were made by digital subtracted angiography (DSA).According to Hunt and Hess'grading:two patient s were grade I,and one was grade II.All of them were treated by embolization therapy with GDC.Result:All of the cases were treated by GDC,neither death nor complication occurred.Conclusion:Though intracranial aneurysm was rare in childhood,endovascular treatment of intracranial aneurysms with GDC is also effective and safe in dealing with pediatric pa-tients,but the long-term effect has to be confirmed by follow-up study in the future.