Objective To summary the results of fixation and fusion with lateral mass screw of atlas and vertebra dentata pedicle screw for the treatment of atlantoaxial instability. Methods From February 2002 to March 2004, 15 cases suffered with atlantoaxial instability were included in this study. There were 9 males and 6 females, with a mean age of 39.5 years old(ranged 15 to 57 years old). There were 5 cases for old odontoid fracture, 4 cases for congenital loose odontoid process, 6 cases for fresh odontoid fracture(Aderson ⅡC). 7 cases were fixed with Vertex, 3 Axis and 5 Cervifix instruments. JOA scores in preoperation were from 5.1 to 10.9, with an average of 7.6. Skull traction was performed in each patient preoperatively. The screws were placed in lateral mass of atlas beside the posterior arch of atlas about 18-20 mm and the point of intersection above 2 mm inferior boarder of posterior arch. Vertical with coronal plane, the tip of the screw made 5? to side of head in sagittal plane. The site of the screws were placed in vertebra dentate was divide equally the inferior articular process of axis, made 15? with sagittal plane and 30? with cross section. The diameter of the screw was 3.5 mm, the length of in lateral mass of atlas was from 28 to 32 mm, and from 22 to 26 mm in vertebra dentate pedicle screw. Results There were no spinal cord and vertebral artery injury after surgery. Follow-up duration was from 10 to 25 months, with average 14 months. The postoperative JOA scores were from 13.2 to 16.8, with average 14.8. The improve rate was 87.5 percent. The plant bones all fused and there were no internal fixation rupture and mobiled. Conclusion Lateral mass screw of atlas and vertebra dentata pedicle screw with three-dimension fixed virtues could be used to treat atlantoaxial instability.

Objective To explore the relationship between the Yangtze River floodplain ecological environment(vegetation, soil,water and light intensity)and the distribution of Oncomelania hupensis snails,so as to provide the evidence for ecological snail control. Methods Three regions(the Lu-Gang Bridge,Dragon Nest Lake in the bund,and Dragon Nest lake beach)were selected to investigate the plant characteristics(species,height,coverage,frequency and strain of clusters),soil characteristics (temperature,humidity,light intensity)and pH value. All the results were analyzed statistically with SPSS 18 software. Results A total of 920 boxes were investigated. The vegetation coverage was 3.7%-63.5%,and the dominant population was Cyperusrotun-dus L. cluster on the marshland. The soil temperature was 19.0℃-24.0℃,pH 5.0-5.7,and humidity 53%-75%. There were statis-tical significants in average number of living snails and dead snails among 3 groups( P<0.05). As the light intensity was strong in summer and weak in winter,the snails were in the back surface in summer and front surface in winter respectively. The average number of living snails was the most near the water. The difference was statistical significant(P<0.01)among three ranges(0-1 m,1-3 m and 3-5 m). Conclusion The snail survival and distribution have close relations with micro ecological environment factors,such as vegetation,soil,water and light intensity.

Objective To investigate the value of detecting hepatitis B virus (HBV) YMDD variants by matrix-assisted laser de-sorption time of flight mass spectrometry (MALDI-TOF MS). Methods The assay is based on polymerase chain reaction (PCR) amplifica-tion and mass measurement of oligonucleotides containing sites of mutation of the YMDD motif. Result The MALDI-TOF MS-based genoty-ping assay was sufficiently sensitive to detect as few as 100 copies of HBV genome per milliliter of serum, and this method had superior spe-cificity for determining mixtures of wild-type and variant viruses. When sera of 40 patients were analyzed, the MALDI-TOF MS-based assay correctly identified known viral variants and additional viral quasi-species not detected by previous methods, as well as their'relative abun-dance. Conclusion The sensitivity, specificity and amenability to high-throughput analysis make MALDI-TOF MS-based assay suitable for mass screening of HBV infected patients who are receiving lamivudine.

Microbial nitrilases have attracted increasing attention in nitrile hydrolysis for carboxylic acid production in recent years. A bacterium with nitrilase activity was isolated and identified as Pseudomonas putida CGMCC3830 based on its morphology, physiological and biochemical characteristics, as well as 16S rRNA gene sequence. The nitrilase production was optimized by varying culture conditions using the one-factor-at-a-time method and response surface methodology. Glycerol 13.54 g/L, tryptone 11.59 g/L, yeast extract 5.21 g/L, KH2PO4 1 g/L, NaCl 1 g/L, urea 1 g/L, initial pH 6.0 and culture temperature 30 degrees C were proved to be the optimal culture conditions. It resulted in the maximal nitrilase production of 36.12 U/mL from 2.02 U/mL. Investigations on substrate specificity demonstrate P. putida nitrilase preferentially hydrolyze aromatic nitriles. When applied in nicotinic acid synthesis, 2 mg/mL P. putida cells completely hydrolyzed 20.8 g/L 3-cyanopyridine into nicotinic acid in 90 min. The results indicated P. putida CGMCC3830 displayed potential for industrial production of nicotinic acid.
Aminohydrolases ; biosynthesis ; Culture Media ; Hydrolysis ; Niacin ; biosynthesis ; Nitriles ; metabolism ; Pseudomonas putida ; enzymology ; Pyridines ; metabolism ; RNA, Ribosomal, 16S ; genetics ; Substrate Specificity ; Temperature

Objective To evaluate the radiological signs of synovial chondromatosis and the diagnostic value of radiology.Methods 36 cases with synovial chondromatosis confirmed by histology were retrospectively analyzed.All 36 cases underwent radiography and 13 of them underwent CT examinations,10 of them underwent MRI.Results The knee in 22 cases,hip in 5 cases,ankle in 3 cases,shoulder in 2 cases,elbow in 2 cases,carpal joint in one case and temporomandibular joint in one case were involved in 36 cases.Of them,one joint involved in 31 cases and bilateral knee joints involved in 5 cases.Multiple calcareous loose bodies with different sized(from several diameter to 2.7 cm)were seen inside or surrounding the joints on X-ray and CT images.In 10 cases with MR examination,the calcareous nodules were low signal intensity on both T_1WI and T_2WI in 8 cases.In other 2 cases,the center of calcareous nodules showed as high signal intensity while the rim showed as low signal intensity.Conclusion X-ray,CT and MRI are of significant value in diagnosis of synovial chondromatosis.

Objective To observe effects of different concentrations of sevoflurane combined with propofol on recovery quality in patients undergoing partial hepatic resection.Methods Seventy-eight patients,aged 20-70 years old,selected for partial hepatic resection were randomly divided into three groups,26 patients in each group:total intravenous propofol anesthesia group (group T), propofol combined with 0.5 MAC sevoflurane anesthesia group (group S1),propofol combined with 1.0 MAC sevoflurane anesthesia group (group S2).Spontaneous respiration recovery time,recovery time,extubation time and modified Aldrete score of 9 time were recorded after operation.Modified OAA/S scores as well as modified Aldrete score at extubation immediate time (T1 )and 5 min (T2 ), 1 5 min(T3 ),30 min(T4 )after extubation were also recorded.Results Total amount of propofol in groups S1,S2 significantly less than group T and total amount of propofol in group S2 significantly less than group S1(P <0.05).The recovery time,extubation time,modified Aldrete score of 9 time in groups S1 and S2 were significantly shorter than group T (P <0.05).Modified OAA/S scores at T1 ,T2 and the modified Aldrete scores at T1 in both groups S1 and S2 were significantly higher than group T,while group S2 was significantly higher than group S1 (P <0.05).Conclusion Compared with total intravenous propofol anesthesia,both propofol combined with 0.5 MAC sevoflurane and propofol combined with 1.0 MAC sevoflurane anesthesia improves the recovery quality in patients un-dergoing partial hepatic resection,and the recovery time was decreased in propofol combined with 1.0 MAC sevoflurane anesthesia.

OBJECTIVE To study the effect of the intervention of monitoring-training-planning(MTP) on use of antibacterials and injections for pediatric acute upper respiratory infection.METHODS In accordance with selected drug use indicators(SDUIS),the pediatric outpatient prescription of acute upper respiratory infection was selected in our hospital from Jun to Aug 2006 as the baseline,and intervented by MTP,then the investigation of post-interfervention was carried out after a month,and then re-intervention research was made,so the cycle continued.RESULTS The percentage ratio of antibacterials,and injection usage,and the average drug fee in pediatric outpatient prescription for acute upper respiratory infection in our hospital was decreased from 75.00%,61.67%,40.33% and 54.29 yuan to 7.00%,5.00%,3.00% and 39.16 yuan,respectively after four rounds of MTP(all P

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Purpose To evaluate parameter changes of pelvic floor muscles in patients with female pelvic organ prolapse (POP) through diffusion tensor imaging (DTI).Materials and Methods Fifty female patients with POP at Ⅲ or ⅣV degree (research group) and fifty healthy women volunteers (control group) were collected to make prospective research.The axial DTI sequence was performed in subjects,with b=500 s/mm2,at 15 directions.DTI original images were imported into the post-processing software,and the corresponding DTI mappings were formed.In the original images,pelvic floor muscles were sketched out layer by layer,and various DTI parameters,including fractional anisotrophy (FA),mean diffusivity (MD),λl,λ2,λ3,linear anisotropy (CL),planar anisotropy (CP) and spherical anisotropy (CS),were calculated.Six kinds of pelvic floor muscles,including anal sphincter,superficial transverse perineal muscle,pubic visceral muscle,puborectal muscle and iliococcygeal muscle were measured,and five of them were measured on both sides.The difference of DTI parameters between right and left side of each muscle,and the difference of DTI parameters between research and control group were compared.Results Between the right and left side of five kinds of pelvic floor muscles in control group,significant difference was only found in FA,λ3,CP,CS value of internal obturator muscle (P＜0.01,P＜0.001).There were significant differences in FA,λ3,CL,CP and CS values of the left and right muscles in the study group (P＜0.05,P＜0.001).Compared with control group,FA value and CS value of superficial transverse perineal muscle,CL value of left pubic visceral muscle,FA,λ3,CL,CS and CP value of right pubic visceral muscle,λ1 and λ3 value of left iliococcygeal muscle of research group were significantly different (P＜0.01,P＜0.05).Conclusion DTI for observation of female pelvic floor muscle is technically feasible,and it can detect the injury of pelvic floor muscle in POP patients,and may be helpful to reveal the pathogenesis of POP.

Objective To compare the influence for intravenous dexmedetomidine and midazolam during combined spinal and epidural anesthesia (CSEA) on sedation,respiratory and circulatory.Methods Ninety patients with lower extremity fractures and internal fixation,were divided into dexmedetomidine group,midazolam group and control group by random digits table with 30 cases each.CSEA was performed at L3-4 interspace.After block reached T8 level,dexmedetomidine,midazolam and 0.9％ sodium chloride were given to the three groups.Ramsay score,mean arterial pressure (MAP),heart rate (HR),partial pressure of carbon dioxide in end expiratory gas (PErCO2),respiratory rate (RR) were recorded before anesthesia(T0),after CSEA (T1),and 10,15,30,45,60 min after giving drug (T2-T6),and intraoperative awareness was recorded.Results Ramsay score in dexmedetomidine group and midazolam group at T2-T6 were higher than those in the group T0,T1 and concurrent control group (P ＜ 0.05),MAP were lower than those in the group T0,T1 and concurrent control group (P ＜ 0.05).HR in dexmedetomidine group at T2-T6 were lower than those in concurrent midazolam group and control group (P ＜ 0.05).PETCO2 in midazolam group at T2-T6 were higher than those in concurrent dexmedetomidine group and control group (P ＜ 0.05),RR were lower than those in concurrent dexmedetomidine group and control group (P ＜ 0.05).The rate of intraoperative awareness in dexmedetomidine group and midazolam group was lower than that in control group [16.7％(5/30) and 13.3％(4/30) vs.93.3％(28/30),P＜0.05].Conclusions Dexmedetomidine and midazolam provide good sedation to reduce intraoperative awareness,slight inhibition of blood pressure.Dexmedetomidine can decrease HR,but it does not influence respiratory function.Midazolam restrains respiratory function.