Animals ; Cochlea ; pathology ; Female ; Guinea Pigs ; Hyperlipidemias ; pathology ; physiopathology ; Male ; Otoacoustic Emissions, Spontaneous

Retinal pigment epithelium ( RPE ) is a vital tissue for the maintenance of photoreceptor function and environment of outer retina, also the predominant cell type of proliferative vitreoretinopathy ( PVR ) . lt is also affected by many diseases of the retina and choroid, including diabetic retinopathy ( DR) , age-related macular degeneration ( AMD ) and retinal pigmentosa ( RP ) . Although of neural origin, the RPE is capable of local repair, and cells may migrate and take on altered characteristics. These findings indicate that RPE-based therapy is a promising option for congenital or degenerate disease of the retina.

Objective To observe the effect of pulmonary surfactant(PS) on lung function and ventilator parameters of neonatal respiratory distress syndrome(NRDS) in the advanced stage.Methods Twenty-eight infants with NRDS were given PS in one dose by endotracheal intubation on the left side,right side,feet high with head low,and level decub respectively.The dose of PS was 100-150 mg/kg each time,each posture slow note of the drug were required 1/4,out of the straw,hand-controlled ventilation,to reduce fluid loss,with the exception of a clear airway obstruction,within 6 hours after the administration not to shoot back suction,to give mechanical ventilation after the injection.Lung function parameters were also measured:pressure of oxygen in artery[p_a(O_2)],carbon dioxide partial pressure[p_a(CO_2)],the ratio of pressure of oxygen in artery and alveolar oxygen partial pressure[a/Ap(O_2)] and oxygenation index(OI) were determined.Ventilator parameters were determined:oxygen concentration(FiO_2),oxygen peak(PIP),end-expiratory positive pressure(PEEP) and mean airway pressure(MAP) were determined.These numerical data were analyzed and compared before and after treatment with PS.Clinical manifestations,thoracic X-ray changes,survival rate and incidence rate of complications were also analyzed and compared before and after PS therapy.Results p_a(O_2),a/Ap(O_2) showed significant upgrade and OI had a decrease after PS administration in comparison with those before PS therapy.The ventilator parameters(except for PEEP) acquired were also lower after drug administration than those in before drug therapy.There were significant differences in both stages(P_a90%,respiratory sound in 24 cases enhanced,the observation of chest film after 24 h indicated that,lesions in 21 cases improved significantly,5 cases took a favorable turn.The survival rate was 85.7%.The incidence rate of complication was as follows:pneumonia was 25%,patent ductus arteriosus was 10.7%,pneumorrhagia was 7.1% and intraventricular hemorrhage was 3.6%,respectively.Conclusion Respiratory function of NRDS is significantly improved by using PS in the advanced stage,and therapeutic effect is apparent.

Objective To observe the polymorphism of nitric oxide synthase(NOS)gene and the changes of nitric oxide(NO)in cerebral infarct.Methods The prospective case-control study was employed.Cases contained 193 subjects with cerebral infarction of internal carotid artery system within 2 weeks.Controls contained 103 subjects which came from the normal health checkup.The polymorphism in intron 4 of endothelial nitric oxide synthase(eNOS)gene were detected.NO content was measured by Griess diazotization assay and NOS activity by enzynatic assay.Results There were 48 subjects with allele a in intron 4 of eNOS gene(eNOS4a)in cases and 12 in controls.The frequencies of eNOS4a in cases was higher than that in controls(χ2=8.86,P=0.003).Multivariate Logistic regression analysis confirmed that eNOS4a was an independent risk factors for cerebral infarction(P=0.032).NO production and NOS activity were 6.04(3.83～11.49)μmol/L,(2.97±1.47)U/ml,respectively in cases,and 6.89(4.64～12.43)μmol/L,(3.16±1.46)U/ml,respectively in controls.NO production in cases were significantly lower than that in controls(P=0.022).There was not differential in NOS activity between these two groups(P=0.517).NO production and NOS activity were 5.07(3.18～7.62)μmol/L,(2.77±1.13)U/ml,respectively in the subjects with eNOS4a,and 6.89(4.64～12.43)μmol/L,(3.12±1.54))U/ml,respectively in the subjects without eNOS4a.NO production in the subjects with eNOS4a were significantly lower than that in the subjects without eNOS4a(P=0.001).The NOS activities were not significantly different in subjects with or without eNOS4a(P=0.100).Conclusion eNOS4a possibly exerted some effects on cerebral infarction by diminishing NO.

A set of teaching methods have been explored and practiced in this paper, which include paying attention to knowledge originating process teaching, enhancing thought training, constructing microbiology knowledge system, concerning reality, following the advanced achievement during the microbiology class teaching process, in order to improve teaching quality overall, cultivate students’ innovative ability.

Objective To discuss the operative methods, timing and outcomes of severe open Pilon fractures. Methods From April 2003 to July 2008, 21 patients with open Pilon fractures were admitted. All the patients were type C fracture according to AO/OTA classification, including 17 cases of type C2 and 4 cases of type C3. According to Gustilo classification, there were 18 cases of type Ⅱ, 2 cases of type ⅢA, 1 case of type ⅢB. The patients were treated in two different ways: one-stage minimally invasive osteosynthesis for reconstruction of the articular surface with transarticular external fixation of the ankle (19 cases),which included 16 cases of Gustilo Ⅱ AO/OTA C2, 2 cases of type Gustilo Ⅱ AO/OTA C3 and 1 case of type Gustilo ⅢA AO/OTA C2. Formal open reconstruction of the articular surface by plating and external fixation was performed when the condition of soft tissue had improved (2 cases), which included 1 cases of type Gustilo ⅢA AO/OTA C3 and 1 cases of type Gustilo Ⅲ B AO/OTA C3. Results All the patients were followed up from 6 to 48 months, with the mean of 24 months. The outcome of reduction was evaluated by the Burwell-Charnley score. Anatomical reduction was found in 6 cases, function reduction was in 14 cases and poor reduction was 1 case. The heal-time ranged from 2.5 to 11 months, with the mean of 4.7 months. The delayed union occurred in 2 cases. The rate of delayed union was 9.5%. Two patients experienced skin superficial necrosis. There were superficial infection in 2 cases and deep infection in 1 case. The infection rate was 14.3%. Eight cases experienced early traumatic arthritis. The incidence of this complication was 38.1%.According to American Orthopedic Foot Ankle Society (AOFAS) scale for ankle joint, the result of the treatment was 66-94, with an average of 85.2. Conclusion It is important to have the optimal timing of surgery and reliable fixation according to fracture classification, the condition of soft tissue and time after injury. It is the key to evaluate the condition of soft tissue and protect the blood supply.

Objective To evaluate clinical outcomes of treating displaced intra-articular calcaneal fractures with Orthofix external fixation (EF) in comparison with open reduction and internal fixation (ORIF).Methods Between February 2013 and December 2014,39 patients with 41 calcaneal fractures were treated operatively and fully followed up at our department.They were 27 men and 12 women,aged from 27 to 56 years(average,42.5 years).The left foot was affected in 15 cases and the right in 26.By the Sanders classification,there were 11 cases of type Ⅱ,22 ones of type Ⅲ and 8 ones of type Ⅳ.The 5 open fractures were Gustilo type Ⅰ (2 cases) and Gustilo type Ⅱ (3 cases).Of the 11 fractures complicated with soft tissue injury,4 were Tscherne-Oestern type Ⅰ and 7 Tscherne-Oestern type Ⅱ.The patients were divided into group EF (25 cases) and group ORIF (16 cases) according to the operation they had received.The 2 groups were compared in intraoperative indexes and follow-up radiological data.The American Orthopaedic Foot and Ankle Society (AOFAS) scores for ankle and hindfoot were recorded at the final follow-up for every patient.Results The mean duration of surgery,intraoperative bleeding,time for hospitalization and bone healing in group EF were significantly less than in group ORIF (P ＜ 0.05).There were no significant differences between the 2 groups in follow-up duration,AOFAS score,Bthler angle,Gissane angle,calcaneal axis,calcaneal horizontal length,tuberosity height,hillock calcaneal height,calcaneal width,or talar inclination angle (P ＞ 0.05).According to the AOFAS scores at the final follow-ups,15 cases were rated as excellent,8 as good and 2 as fair in group EF while 10 were rated as excellent,5 as good and one as fair in group ORIF.Conclusions All types of calcaneal fracture can be treated using Orthofix external fixation which may lead to advantages of earlier surgery regardless of soft tissue condition,minimal invasiveness with less devascularization to the calcaneus and decreased risk of complications,and good clinical outcomes.

Objective To systemically evaluate the effects of combined Chinese and western medicine in improving endometrial receptivity. Methods A search for relevant articles ran on the CNKI, WanFang, VIP, PubMed, EMBASE and Cochrane library. The randomized controlled trails of combined Chinese and western medicine therapy versus western medicine alone for improving endometrial receptivity were retieved The Revman 5.3 software was used for Meta-analysis according to Cochrane system evaluation method. Results A total of 7 randomized controlled trails involving 499 patients were included. There was statistically significant difference in the growth of clinical pregnancy rate [RR=1.78, 95％ CI (1.41, 2.26)], the increase of patients with endometrial thickness [MD=1.42, 95％ CI(1.27, 1.58)], the raise of the proportion with type A endometrium [RR=1.25, 95％ CI (1.07, 1.45)], the reduction of the patients with endometrial PI [SMD=-1.41, 95％ CI (-2.18,-0.64)]. There was no statistically significant difference in the reduction of endometrial RI [SMD=-1.11, 95％ CI (-2.52,0.30)]. Conclusions The therapy integrated Chinese and western medicine for endometrial receptivity is better than simple western medicine. But there is less literature on the high quality, suggesting that the methodology of clinical research should be further improved in the future.

OBJECTIVETo compare clinical outcomes between two suturing methods using non absorbable materials through drilling the bone and suturing anchors for the treatment of complete rupture of the deltoid ligament.

METHODSFrom January 2009 to January 2013, 58 hospitalized patients with ankle fracture combined with complete rupture of the deltoid ligament were treated with suturing using non absorbable materials through drilling the bone or suturing anchors. There were 29 patients who received suturing treatments using non absorbable materials through drilling the bone (Group A), including 18 males and 11 females, with an average age of (39.76 +/- 11.81) years old. According to the Lauge-Hansen classification, 12 patients had supination external rotation (SER) injuries with IV degree, 5 patients had pronation external rotation (PER) injuries with III degree, 10 patients had PER injuries with IV degrss, and 2 patients had pronation abduction injuries with III degree. There were 29 patients who received treatments with suturing using anchors (Group B), including 14 males and 15 females, with an average age of (41.79 +/- 13.28) years old. According to the Lauge-Hansen classification,9 patients had SER injuries with IV degree, 6 patients had PER injuries with III degree,13 patients had PER injuries with IV degree, and 1 patient had pronation abduction injuries with III degree. All the patients were treated with open reduction and internal fixation, as well as reconstruction of deltoid ligaments to restore the stability of the medial ankle structures. The clinical examination, imaging evaluation, American society for ankle surgery (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) were used to evaluate the clinical results after operation, and the results of the two groups were compared and analyzed statistically.

RESULTSThe follow-up duration of the 58 patients ranged from 23 to 40 months,with an average of 27.3 months. All the patients had fracture union, and the mean healing time was 12.3 weeks (ranged, 10 to 17 weeks). There were no incision complications and ankle instability. There were no significant differences between two groups in AOFAS (P=0.666) and the VAS (P=0.905).

CONCLUSIONTreatments of complete rupture of the deltiod ligaments with the two suturing methods get similar good clinical effects, but the suturing using non absorbable materials through drilling the bone has several advantages such as reducing the financial burden of patients, saving social medical resources and avoiding the shortcoming in difficult removal of anchor suture.

Adolescent ; Adult ; Ankle Fractures ; surgery ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Lateral Ligament, Ankle ; injuries ; surgery ; Male ; Middle Aged ; Young Adult

Objective To investigate the prevalence of mutation in the locus 306 of embB gene in multi-drug resistant (MDR) Mycobacterium tuberculosis (TB) and evaluate the prospects for using it as a molecular marker to detect MDR-TB.Methods The 291 strains enrolled in this study were from the reference laboratory of Shanghai municipal centers for disease control and prevention, all of which had been tested for drug susceptibility.Mutation in embB 306 was screened both by amplification refractory mutation system (ARMS) and DNA sequencing.The mutation frequencies of embB 306 in the sample groups varied in drug resistance were statistically analyzed.Results 38(51.4% ) of the 74 MDR-TB were embB 306-mutant (X2 =93.8,P＜0.01).Of the 24 TB resistant to at least two drugs but not MDR, 9(37.5% ) were embB 306 mutant (X2 =60.1 ,P＜0.01 ).But only two(4.9% ) embB 306-mutant strains were found in 41 strains resistant to only one drug (X2 =6.8,P=0.0093).None embB 306-mutant strains were found in 152 pansensitive strains.The specificity of using embB 306 as a molecular marker for detecting multi-drug resistant TB was 94.9% (206/217).Conclusions As a molecular marker for screening drug resistant TB,especially MDR-TB, the gene locus embB 306 shows a relatively high sensitivity and specificity, promising a sound future for its application in clinics to realize fast screening of patients infected with MDR-TB and to provide evidence for appropriate medication.