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 investigate the clinical and epidemiological characteristics of osteosarcoma in China and analyze the incidence and clinical treatment of osteosarcoma.Methods The clinical data of 1 593 patients with osteosarcoma in 7 bone cancer treatment centers from January 2000 to February 2017 were analyzed.We retrieved large samples of documents in the database,extracted the relevant data and compared the data with this study.SPSS 13 software was used for statistical analysis and each factor was tested by x2.Results Of 1 593 patients,984 were males and 609 were females.The ratio of male to female was 1.62∶ 1.The average age was 23.2 years (range from 3-80 years).The peak age of onset was 11-20 years (52.4％).There were 217 elderly patients (＞ 40 years old).The tumors occurred in 1 524 limbs and 69 in axial bone.The most common sites of disease were distal femur 706 cases,proximal tibia 375 cases,distal humerus 117 cases and others 395 cases.There were 1 154 cases (71％) around the knee joint.The axial bone included 18 cases of spine,49 cases of pelvis and 2 cases of rib.Preoperative biopsy was performed in 1 111 cases and incisional biopsy in 280 cases.Preoperative diagnosis could be made in 1 345 cases (84.4％ of all patients,accounting for 96.7％ of biopsy patients).There were 79 cases with metastasis at first visit,accounting for 5％.Preoperative chemotherapy was performed in 1 185 cases (74.4％).With the DIA preoperative chemotherapy 271 cases,DIA+MTX 251 cases,AP 149 cases.220 cases of tumor cell necrosis rate was evaluated after operationaccording to the Huvos classification.There were78 cases of grade Ⅰ,105 cases of Ⅱ grade,35 cases of Ⅲ and 2 cases of grade Ⅳ.There were 1 299 cases undergoingpostoperative chemotherapy (81.5％),1 306 patients undergoinglimb salvage surgery (82％).Thespecific operation with prosthetic replacement is the most common (911 cases,69.8％).The postoperative chemotherapy included DIA+MTX regimen 471 cases,DIA regimen 266 cases and AP regimen 98 cases.Before and after the operation,379 cases were treated with the same chemotherapy regimen and 666 cases were changed.A total of 18 large sample documents were retrieved in Chinese data base (5 684 cases).The sex ratio,age range,peak incidence and location of the disease were similar to those of this study.The average age was 1-2 years old younger.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage waslowand the rate of tumor necrosis wasbetter after chemotherapy.A total of 22 large sample literatures were searched in foreign database (12 850 cases).The ratio of men and women is 1.30∶1 and the proportion of women is higher than the domestic data.The average age was 1-2 years older.The ratio of the knee joint was lower.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage were similar to that of this study and the rate of tumor necrosis was better after chemotherapy.Conclusion The general situation of the incidence of osteosarcoma (sex,age,location of the disease) is not significantly different from the previous reports both at home and abroad.In the treatment,preoperative and postoperative chemotherapy rate and limb salvage surgery rate have improved significantly compared with the past.The chemotherapy program from the coexistence of various programs,gradually to the DIA+MTX and DIA program as the mainstream program.