[Objective] To investigate the characteristics of senile diabetic hip fracture in the peri-operation stage and to summarize the experience for its treatment. [Methods] A retrospective study was conducted in 21 cases of senile hip fracture complicated with diabetic mellitus which had received operation. [Results] No case was dead and no case was infected after operation; the incision was healed well and the patients went through the peri-operation stage safely. [Conclusion] On the basis of effectively controlling the blood sugar level, operation can be taken into consideration and pre-operative and post-operative treatment should also be emphasized.

OBJECTIVE To investigate the applicability of 3DMIA software to upper airway modeling in children with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS A total of 30 children diagnosed with OSAHS by polysomnography were included in this study. Data regarding upper airway structure were collected via spiral CT while sleeping and awake, from which a three-dimensional model of the upper respiratory tract from the nasopharynx to the supraglottic region using 3DMIA software was constructed. The upper airway volume and airway minimum cross-sectional area were measured employing software algorithms. RESULTS The upper airway volume and airway minimum cross-sectional area of the 30 children during sleep were significantly less than those while awake (P<0.01). CONCLUSION 3DMIA software modeling and software algorithm measurement are more objective than traditional radiology (e.g. Fujioka) with respect to evaluation of the extent of the upper airway narrowing in OSAHS children, and has good applicability to study upper airway morphology and function in children with OSAHS.

Objectives To observe the clinical efficacy of combined treatment with montelukast and intranasal steroid for chronic adenoid hypertrophy in children. Methods 47 children with chronic adenoid hypertrophy were selected and ran-domly divided into drug combination group (n=23) treated with montelukast combined with intranasal steroids for two months and control group (n=24) treated with intranasal steroids only for two months. Clinical efficacy was compared between two groups by clinical score and the result of fibronasopharyngoscopy. Results The clinical scores were 0 (0, 1.0) and 0(0, 0) at 2 weeks and 2 months after treatment in combination group, and 1.0 (1.0, 1.0) and 0 (0, 1.0) in control group. There were sig-nificant differences between two groups (Z=2.404, P<0.05;Z=2.069, P<0.05). Conclusions The clinical efficacy of combined treatment with Montelukast and intranasal steroid is better than that of treatment with intranasal steroid only in children with chronic adenoid hypertrophy.

Objective To investigate the clinical application of the coblation in the treatment of the infant with sleep-disordered breathing. Methods The clinical data were reviewed from 161 infants, who had the cobtilaon tonsillectomy and/or adenoidectomy sugeries in our hospital from January , 2008 to June, 2012. Among the 161 SDB cases, there were 85 obstructive sleep apnea hypopnea syndrom cases and 76 primary snoring cases. After 12 months, the follow-up visit is cut off in January, 2013. Successful follow-ups had been done to 161 infant with SDB. And the clinical efficacy and the occurrence of the complications were investigated. Results the intra-operative blood loss was 10 mL or less. 2(1.24%) were delayed hemorrhage with less pain afteroperation. One year after the surgery, there were 141 cured (87.6%), 15 with apparent effects (9.3%), 3 with effective results (1.9%), 2 with no effect(1.2%)and the total effective rate is 98.8%. Conclusion It is minimally invasive, safe and effective to use coblation to remove tonsil and adenoid in the treatment of infants with sleep-disordered breathing.

OBJECTIVE To study the relationship between the level of high sensitive C-reactive protein (hs-CRP)and obstructive sleep apnea/hypopnea syndrome(OSAHS)in children. METHODS Between 2008 and 2009, 30 children who were diagnosed OSAHS, were enrolled in OSAHS group. Thirty children with a history of chronic tonsillitis made up chronic tonsillitis group. Thirty children(27 children were diagnosed accessory auricle and 3 children with laryngeal web)consisted of the control group. The three groups were matched by age, sex and BMI. Children in OSAHS group underwent overnight polysomnography monitoring in our medicine sleep center. Samples for plasma hs-CRP level were collected in the morning. RESULTS 1. The difference of plasma hs-CRP level among three groups was not significant (?2=0.179,P=0.914). 2. Plasma hs-CRP level did not correlated with AHI, BMI and lowest saturation of blood oxygen(rs=0.343, 0.104 and-0.062; P=0.064, 0.584, and 0.747, respectively). CONCLUSION Higher hs-CRP values were not observed in children with OSAHS. There are no correlation between hs-CRP and AHI, BMI and lowest saturation of blood oxygen.

OBJECTIVE To investigate the value of rigid bronchoscope combined with fiber bronchoscope application in children with airway obstruction.METHODS Retrospective analysis of 176 cases children with airway obstruction from January 1, 2006 to January1, 2016, all patients were diagnosised and treated in our hospital. RESULTS All children were acceptted rigid bronchoscopy combined with fiber bronchoscope under general anesthesia, then received the different thrapy according to the different causes. 104 patients with airway foreign body were all obtained satisfactory effect, 2 cases of children with bronchial foreign body(cap) inspection, failed to remove and contact thoracic surgery doctors to remove the foreign body by thoracotomy. 10 plastic bronchitis patients improved after treatment or cured. 7 cases of bronchial tuberculosis were cured after treatment. 4 patients with airway tumor after minimally invasive surgery, obtained good effect, 2 cases were turned to the other cancer hospital. 2 cases of patients with tracheal stenosis, the symptom is reduced after expansion. Bronchial granulation, tracheomalacia, bronchial softening, bronchial atresia patients improved after treatment. This group of all patients with pneumonia were cured after symptomatic treatment.CONCLUSION Rigid bronchoscopy and fiber bronchoscope are both useful for diagnosis and treatment of children with airway obstruction, both have its advantages and disadvantages, combined application can improve the accuracy of disease diagnosis and timely intervention on the patients.

Objective To observe the efficacy of intravitreal injection of ranibizumab (IVR) for different patterns of optical coherence tomography (OCT) of diabetic macular edema and the relationship between integrity of ellipsoidal zone and visual acuity outcomes.Methods Eighty-five IVR treated eyes were enrolled.The examination of BCVA was according to Early Treatment Diabetic Retinopathy Study,and the results were recorded as logarithm of the minimum angle of resolution (logMAR).Frequency-domain OCT was used to measure the central foveal thickness (CFT) and the integrity of ellipsoidal zone.All eyes were classified as diffuse macular edema (DRT group,31 eyes),cystoid macular edema (CME group,29 eyes),and serous retinal detachment (SRD group,25 eyes).All the patients were treated with intravitreal injection of 0.05 ml (0.5 mg) ranibizumab.The mean follow-up time was (9.21+3.56) months after IVR treatment.The changes of BCVA and CFT in 3 groups were compared and analyzed after 3,6 and 12 months.According to visual acuity at different ranges,the relationship between integrity of ellipsoidal zone and BCVA was analyzed.Results Compared with the average logMAR BCVA before treatment,except for 12 months after treatment in group SRD (t=2.104,P=0.053),the average logMAR BCVA after IVR at 3 months,6 months and 12 months improved in DRT group (t=7.847,6.771,6.426;P=0.000,0.000,0.000),CME group (t=8.560,6.680,5.082;P=0.000,0.000,0.000) and SRD group (t=5.161,3.968,2.104;P=0.000,0.001,0.053).The average logMAR BCVA of the DRT group was lesser than that in CME and SRD group after 12 months treatment (t=-2.043,-3.434;P=0.030,0.001).The average CFT after IVR at 3 months,6 months and 12 months reduced significantly in DRT group (t=12.746,10.687,9.425;P=0.000,0.000,0.000),CME group (t=13.400,11.460,10.169;P=0.000,0.000,0.000),and SRD group (t=1 1.755,10.100,9.173;P=0.000,0.000,0.000).After 12 months of treatment,the average CFT of the SRD group was thicker than that in DRT group and CME group (t=-3.251,-1.227;P=0.003,0.025);there was significant difference in the integrity of ellipsoidal zone among 3 groups (x2=1.267,P=0.531).The results showed that there were significant differences in the integrity of ellipsoidal zone with different ranges of BCVA before and after 12 months treatment (x2=20.145,41.035;P=0.000,0.000).Conclusions IVR could significantly improve the visual acuity of different patterns of DME,reduced the CFT,and had the best efficacy in the DRT group.There was relationship between the integrity of ellipsoidal zone and the visual acuity outcomes.

Background The scarring of conjunctival filtering blebs after glaucomatous surgery is a leading cause of operation failure.Exploring the balance between matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in conjunctival filtering bleb is very important for the study on pathogenesis of postoperative scarring.Objective This study was to evaluate the role of MMP-2 and TIMP-2 in wounding healing of subconjunctival tissue after filtering surgery in rats.Methods Sixty-three clean male SD rats were divided into normal control group and postoperative 1-day,3-day,5-day,7-day,14-day and 28-day group.The drainage tube was monocularly implanted into the anterior chamber of the rats to establish the filtering surgery models,and the operative response of the eyes was examined under the slit lamp microscope.The animals were sacrificed in corresponding time points,and the frozen sections of eyeballs were prepared,and the expressions of MMP-2 and TIMP-2 in conjunctival and subconjunctival tissues were detected using immunofluorescence technique.Western blot was employed to assay the dynamic expressions of MMP-2 and TIMP-2 proteins in conjunctival and subconjunctival tissues in different groups.The use and care of the rats complied with the Instruction Notions with Respect to Care for Laboratory by State Ministry of Science and Technology.Results Filtering blebs were formed in all the operated eyes 1 day after surgery and remained for 7-17 days,with the average survival time of 12 days.Western blot assay revealed that the expression levels of MMP-2 protein in the filtering blebs of the normal control group were 121.67 ±4.37,and the expressions were gradually elevated from the postoperative 3-day group (183.67±5.61) until the postoperative 7-day group (230.50±8.48) and then gradually declined till the postoperative 28-day group (172.33 ± 8.43),showing a significant difference among the groups (F=280.18,P＜0.05).In addition,the expression levels of TIMP-2 protein in filtering blebs of the normal control group were 102.50 ±6.25.The expression levels were gradually raised in postoperative 3-day group (162.67±7.00) and peaked in the postoperative 5-day group (232.00± 11.03),and then the levels gradually reduced till the postoperative 28-day group (150.50±6.41),with a significant difference among the groups (F =145.34,P ＜ 0.05).Immunofluorescent staining showed that MMP-2 and TIMP-2 were weakly expressed in the conjunctival epithelium of the normal rats,while in the operated rats,strong fluorescence for MMP-2 and TIMP-2 was seen in both conjunctival epithelium and subconjunctival tissues of filtering blebs.Conclusions The expression trends of MMP-2 and TIMP-2 in the filtering blebs are consistent to the fibrosis process of conjunctival tissue,indicating that MMP-2 and TIMP-2 participate in the scar formation of conjunctival filtering bleb after glaucoma filtering surgery.

BACKGROUND:Until now, there is yet no complete recovery from spinal cord injury in terms of structure and functional recoveries. Neurotrophic factors have limited effects on nerve regeneration. Currently, stem cel transplantation may be an effective way to repair spinal cord injury.
OBJECTIVE:To separate, cultivate and purify mouse spinal cord-derived neural stem cels using serum-free suspension method folowed by morphological observation, immunofluorescence technology and multi-lineage differentiation experiments.
METHODS:By using the suspension culture method, mouse spinal cord-derived neural stem cels at embryonic day 13.5 were cultured and purified. Cel morphology changes were observed under inverted microscope. Cel proliferation ability was detected using cel counting kit-8. Nestin and Sox2 expression was detected by immunofluorescence technology. Multilineage differentiation of spinal cord-derived neural stem cels at passage 4 was detected by natural differentiation method in order to prove the differentiation ability.
RESULTS AND CONCLUSION: Serum-free medium suspension culture method was successfuly applied to separate spinal cord-derived neural stem cels. Cultured cels had good proliferative ability and highly expressed Nestin and Sox2 that was in accordance with the results of DAPI nucleus staining, suggesting the high purity of cels. After induction, the cels could express both Tuj1 and GFAP, indicating the cels had good differentiation potential. This experiment has successfuly established the isolation, culture, identification system of spinal cord-derived neural stem cels, providing experimental basis for subsequent studies of neural stem cels.

Objective:To compare low temperature coblation assisted tonsillectomy with conventional dissec-tion tonsillectomy intraoperation and afteroperation. Method:Ninty-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocare EVac 70 T&.A Wand was used for cobla-tion-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded seperately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of afteroperation. Result: Coblation assisted group had a shorter operative time than the control group (10. 2min vs. 36. 5min, P<0. 001). The average amount of intraoperative bleeding of Coblation assisted group was(6. 83±3. 36) ml, while the control group was(30. 07±7. 04)ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group, who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. Conclusion: Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding,shorter operation time,earlier return to normal diet, less pain on 1st to 3th day postoperatively.