ObjectiveTo explore the radiological features of hypophosphatasia.MethodsFive cases of hypophosphatasia were definitely diagnosed,which included 3 males and 2 females aged from 5 months to 23 years.The laboratory assays were analyzed,radiological appearances of bone were determined and differential diagnoses were made.ResultsThe alkaline phosphatase in blood serum of five patients decreased,which were 8,20,13,21,and 18 U/L respectively.Phosphoethanolamine increased in blood serum of the five patients,which were 16.5,13.5,21.6,18.7,and 28.9 μmol/L respectively.Phosphoethanolamine also increased in urine,which were 2350,9120,3520,5280,and 1820 μmol/L respectively.Calcium in blood serum increased,which were 4.2,5.6,4.9,6.1,and 3.5 mmol/L respectively.X-ray images displayed that the density of bone decreased in 5 cases,the metaphyses exhibited widening and cupping in 4 cases,the provisional calcification zone of the metaphysis became thinning or disappearing in 4 cases,long bone bended in 4 cases and pathologically fractured in 1 case.Conclusion Hypophosphatasia can be indicated by its relatively special radiological appearance,and it can be diagnosed and differentiated from rickets,osteomalacia and osteogenesis imperfect by the laboratory examination combined with its clinical presentation.

Objective: To observe the clinical efficacy of combined needle-embedding and SSRIs for depressive sleep disorder. Method: Upon admission, 71 depression cases were randomized into needle-embedding group of 24 cases, using combined needle-embedding and SSRIs, acupuncture group of 21 cases, using combined acupuncture and SSRIs, and medication group of 26 cases, using SSRIs alone. After 1, 2, 4 and 6 weeks of treatment, the HAMD sleep scores were compared. Result: The HAMD sleep scores in the needle-embedding and acupuncture group were remarkably superior to the medication group and there was significant statistical difference after 1, 2 and 4 weeks of treatment (P<0.01). However, there was no statistical difference after 6 weeks of treatment. Conclusion: SSRIs can improve HAMD sleep scores. The combined needle-embedding or acupuncture with SSRIs can work faster and better than medication alone. There was no statistical difference between needle-embedding and acupuncture group, however, needle-embedding can reduce the treatment frequencies and therefore has more active clinical meaning.

Objective To evaluate the clinical value of regular and dual-time-point 18-fluorodeoxyglucose positron emission tomography-CT(FDG PET/CT)imaging for recurrence and metastasis in esophageal carcinoma(EC)after curative esophagectomy. Methods A retrospective study was done on 48 patients received curative esophagectomy, who underwent FDG PET/CT scans to detect doubtful recurrent or metastatic lesions. The diagnostic accuracy of FDG PET-CT was assessed with the help of pathological findings as well as clinical or follow-up data. Using Fisher's Exact Test from SPSS 11.5 to analyze the data.Results Of the 48 patients, after a median follow-up of 21.5 months, 61 sites of local and regional recurrence or metastasis were finally confirmed in 34 patients. The sensitivity, specificity and accuracy of regular FDG PET/CT imaging in detecting recurrence of all sites were 93.44%, 74.29% and 86.46%respectively. The specificity and accuracy of local recurrence and regional metastasis were 57.14% ,78.95% and 77.78% ,84.62%, respectively. The sensitivity, specificity and accuracy of dual-time-point FDG PET/ CT imaging in detecting local and regional recurrence(96.97% ,96.00% and 96.55%)were higher than those of regular FDG PET/CT(90.90%, 72.00% and 82.76%)and there were significant differences of specificity and accuracy(P = 0.049, P = 0.029). Conclusions Regular FDG PET/CT imaging is highly effective in detecting recurrence and metastasis in EC patients after curative esophagectomy despite the low specificity and accuracy. Dual-time-point FDG PET/CT imaging can elevate the specificity and accuracy.

Objective To observe the formation of the biofilm in endotracheal tubes,the characteris-tics of etiology, drug resistance and relationship between the biofilm and ventilator-associated pneumonia ( VAP) . Methods A total of 60 cases of ventilated children patients whose mechanical ventilation time were≥48 h in the ICU from September 2010 to September 2012,according to the mechanical ventilation time,all cases were divided into 2 to 6 d group,7 to 14 d group and ≥15 d group. The incidence of VAP, biofilm structure under the electron microscope,etiology culture positive rate of the lower airway secretions and bio-film,etiological characteristics and drug resistance were prospectively studied. Results ( 1 ) A total of 19 cases occurred VAP in 60 cases of mechanical ventilation,the incidence of VAP was 31. 7%. (2) Observed by electron microscope,biofilm had formed in the endotracheal tube inner wall in early period of mechanical ventilation. With prolonged mechanical ventilation,biofilm structure had improved,as well as VAP incidence rate from 9. 1%(2 to 6 d group ) increased to 44. 4%(7 to 14 d group) and 88. 9%(≥15 d group). (3) A large number of pathogenic bacteria colonized in the biofilm. Gram-negative bacilli were dominate and drug resistance was high. (4) With prolonged mechanical ventilation,the cultured pathogens from the lower airway secretions and biofilm converged. Conclusion Biofilm could form in the endotracheal tube with mechanical ventilation patients,and is associated with the occurrence of VAP and refractory infections.

Objective: To observe the effect oftuina plus music therapy on range of motion of ankle joints and muscle spasm of lower limbs in children with spastic cerebral palsy. Method:All of 286 cases that conformed to the diagnostic criteria of infantile cerebral palsy were treated with 7 types of tuina manipulations respectively to unblock the Governor Vessel, reinforce the kidney and strengthen the spleen, pinch along the spine, stimulate specific foot-reflex area and different spinal segments, accelerate recovery of muscle strength and increase joint range of motion, 25-30 rain each treatment, once or twice a day, 30 d constitute a course of treatment.After this, the efficacy on femoral medial adduction and dorsiflexion angle and composite spasticity score (CSS) was evaluated. Result: The statistical analysis showed significant differences in dorsiflexion and femoral medial adduction angle and CCS scores (P<0.01) after the treatments. Conclusion: Tuina plus music therapy can lubricate the joints, relax contraction of tendons, alleviate muscle spasm and improve scissors and toe-walking gaits, thereby benefiting the gross motor function of infants in sitting, kneeling, standing and walking.

Objective: To compare the effect of scalp acupuncture and scalp acupuncture plus acupuncture exercise therapy (AET) on walking ability in children with spastic cerebral palsy (CP). Methods: A total of 60 spastic CP children with gross motor function classification system (GMFCS) grades Ⅰ-Ⅲ were divided into a control group and an observation group by the random number table method, with 30 cases in each group. Both groups were treated with the same conventional rehabilitation and scalp acupuncture therapy for CP. The control group received conventional rehabilitation first and then scalp acupuncture. The observation group received AET, which was to receive the conventional rehabilitation and scalp acupuncture simultaneously. Before and after treatment, the clinical efficacy was evaluated by the modified Ashworth scale (MAS) score, scores of dimensions D and E of the gross motor function measure (GMFM) scale, walking speed, and walking distance. Results: During treatment, there were 2 dropouts in the observation group. After 3 courses of treatment, the MAS scores in both the control group and observation group decreased compared with the same group before treatment (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance were increased (P<0.05); the between-group comparison showed that the MAS score in the observation group was lower than that in the control group (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance in the observation group were higher or longer than those in the control group (P<0.05). Conclusion: W ith the same treatments, scalp acupuncture combined with AET is superior to the conventional scalp acupuncture method in reducing lower-limb muscle tone, improving standing balance ability, and walking stability in children with spastic CP.

OBJECTIVETo determine 5-lipoxygenase (5-LOX) expression and the effect of zileuton, a selective 5-LOX inhibitor,on hippocampal neuron injury induced by global cerebral ischemia in rats.

METHODSGlobal cerebral ischemia was induced by bilateral common carotid artery occlusion combined with hypotension in rats. 5-LOX expression was detected by Western blot analyses and 5-LOX localization was visualized by immunohistochemistry and double immunofluorescence methods. The 5-LOX inhibitor zileuton (10, 30, 50 mg/kg) was orally administered for 3 d after ischemia.

RESULTSThe 5-LOX expression was increased in the ischemic hippocampus on d1-7 (peaked at d3), and 5-LOX protein was primarily localized in neurons and translocated to the nuclei in the hippocampal CA1 region after ischemia. The 5-LOX inhibitor zileuton (30, 50 mg/kg) reduced ischemia-induced hippocampal neurons death 3d after ischemia.

CONCLUSION5-LOX is involved in global cerebral ischemic damage in rats, and the 5-LOX inhibitor zileuton has a protective effect on neuronal damage in the rat hippocampus following global cerebral ischemia.

Animals ; Arachidonate 5-Lipoxygenase ; metabolism ; physiology ; Brain Ischemia ; metabolism ; pathology ; CA1 Region, Hippocampal ; metabolism ; pathology ; Disease Models, Animal ; Hydroxyurea ; analogs & derivatives ; pharmacology ; Lipoxygenase Inhibitors ; pharmacology ; Male ; Neurons ; drug effects ; pathology ; Rats ; Rats, Sprague-Dawley

Bone tissue engineering may provide an alternative to the repairs to skeletal defects resulting from disease, trauma or surgery. Scaffold has played an important role in bone tissue engineering, which functions as the architecture for bone in growth. In this paper, the authors gave a brief introduction about the requirement of bone tissue engineering scaffold, the key of the design of scaffolds and the current research on this subject.
Biodegradation, Environmental ; Bioprosthesis ; Bone Substitutes ; chemistry ; metabolism ; Mechanics ; Surface Properties ; Tissue Engineering ; methods

The clinical data of a 64-year-old patient with adrenocortical adenoma complicated with inferior vena cava tumor thrombus(IVCTT) were retrospectively analyzed. The patient was admitted becourse of intermittent dizziness for 4 months. CT examination revealed right adrenal tumor, and IVCTT was found in operation. Adrenal cortical adenoma needs to be distinguished from adrenal cortical carcinoma pathologically. Preoperative color Doppler ultrasonography, CT angiography or inferior vena cava angiography can confirm the diagnosis of IVCTT and tumor thrombus grade, and different surgical methods should be selected according to tumor thrombus grade.

Objective To observe the formation of the biofilm in endotracheal tubes,the characteristics of etiology,drug resistance and effect on the biofilm and ventilator-associated pneumonia (VAP) of inhaled N-acetylcysteine (NAC).Method We selected 117 tracheally intubated and undergoing mechanical ventilation for ≥48 h in our hospital ICU from September 2010 to August 2012.All the cases were randomly divided into control group (60 cases) and study group (57 cases).The patients in the study group were treated with different doses of aerosolized NAC according to different ages,starting the first administration within 12 hours of mechanical ventilation,once every 8 hours,until stopping mechanical ventilation.Comparison was performed on the two groups in biofilm structure under the scanning electron microscopy,biofilm culture positive rate,VAP incidence,the etiology and drug resistance of the lower airway secretions and biofilms.Result (1) Electron microscopy showed that biofilm had formed in the endotracheal tube inner wall in early period of mechanical ventilation.With prolonged mechanical ventilation,biofilm structure improved.At the same time of mechanical ventilation,the thickness of biofilm in the study group decreased as compared with the control group.(2) Biofilm culture positive rate and incidence of ventilator-associated pneumonia decreased in the study group compared with in the control group (65％(37/57) vs.80％(48/60),P＜0.05;11％ (6/57)vs.32％(19/60),P＜0.01).(3) Alarge number of pathogenic bacteria colonized in the biofilm and gram-negative bacilli dominated.With prolonged mechanicalventilation,theculturedpathogensconvergedfromthelowerairwaysecretionsandbiofilm.Conclusion With prolonged mechanical ventilation,biofilm structure was improved.Inhalation of NAC can inhibit biofilm formation and reduce the incidence of VAP.