Objective To investigate the effect on thyrotropin (TSH) levels of pregnant women and their newborns in different delivery ways. Methods The serum TSH levels of 213 pregnant women and the umbilical cord blood TSH levels of their newborns (140 cases from normal vaginal delivery, 38 cases from cesarean section, 35 cases from low forceps delivery) were tested by immunoradiometric assay. Urinary iodine was detected from pregnant women before delivery. Results In pregnant women, the mean serum level of TSH in the forceps group [(4 13?0 69) mU/L] was significantly higher than those of the normal birth group [(2 58?0 87) mU/L, P

High frequency ventilators(HFV) are introduced in such aspects as its contribution to the development of the ventilation, phylogeny, working principle in the physiological field, the advantages over normal-frequency ventilation, three common HFV modes and their application to medical therapy. The present situation of HFV is analyzed as well as it's developing trends and prospects.

Objective To investigate the effects of Compound Ganduqing Decoction(CGD) on activation and apoptosis of iron overloading hepatic stellate cells(HSC).Methods The cultured HSC-T6 cells were used for experimental cells,and were divided into normal control group,model group and CGD treatment group(in the dose of 0.08g/L).HSC model of iron overloading was induced by incubation with ammonium iron citrate.Immunohistochemical assay was used for the detection of alpha smooth muscle actin(?-SMA) expression.Quantitative polymerase chain reaction(PCR) was applied for the detection of transforming growth factor beta 1(TGF-?1) mRNA expression.TUNEL technique was used for the examination of apoptosis of HSC-T6.Electron microscope was used for the observation of ultrastructure of HSC-T6.Results In the normal control group and the model group,there showed large amount of ?-SMA expression in HSC-T6,but little apoptosis.However,in CGD group ?-SMA expression was decreased obviously,TGF-?1 mRNA expression was reduced,and apoptosis of HSC-T6 was obvious(P

Objective To evaluate the clinical effect of one-stage posterior-anterior approach surgery for patients with cervical fracture and dislocation combined with locked facet.Methods A retrospective review was conducted on 21 cases of cervical dislocation and fracture combined with locked facet treated by one-stage posterior-anterior approach surgery between April 2011 and December 2012.There were 16 males and 5 females at age ranging from 23 to 61 years (mean,38.3 years).Posterior unlocking reduction by partial facetectomy and lateral mass screw fixation was performed,followed by anterior decompression,internal fixation and interbody fusion by titanium meshes.Outpatient or telephone follow-up was performed to evaluate bone fusion and recovery of neurologic function.Results Mean operation time was 140 minutes (130-210 minutes) and mean blood loss was 340 ml (range,150-600 ml).All incisions got primary healing with no operation-correlated complications.Five patients complicated with severe lung infection after surgery and one died of respiratory failure two week later.Titanium meshes achieved bone fusion within 3-9 months (mean,6 months) after surgery.At a mean follow-up of 17 months (range,12-30 months),there was no implant breakage and mesh displacement or collapse.According to the American Spinal Injury Association (ASIA) score,preoperative neurologic deficit restored by mean one grade at final follow-up.Conclusion One-stage posterior-anterior approach surgery is an ideal choice for cervical fracture and dislocation combined with locked facet,for it provides unlocking reduction,canal decompression,and rigid reconstruction of the anterior-posterior column.

Objective To compare the minimum 5?year follow?up outcomes of surgical management by posterior only, anterior only and combined posterior and anterior approaches for lumbar tuberculosis in adults, evaluate the mid?term follow?up results of the surgery for the treatment of lumbar tuberculosis and explore its advantages and indications. Methods From Jun 2004 to Jan 2010, 311 adult patients with lumbar tuberculosis were treated surgically. The clinical data of 137 cases that met the enrolled criteria and had integrity following?up data was analyzed retrospectively. It included the patients who had the surgical indication of the posterior only surgery but underwent the anterior only or the combined posterior and anterior ap?proaches before 2008. There were 83 cases of male and 54 cases of female. The age ranged from 20 to 75 years, with a mean of 65.6 years. Among these patients, 63 cases were treated with single?stage posterior debridement, interbody fusion and instru?mentation (the posterior group); 42 cases were treated with posterior instrumentation, and anterior debridement and bone graft in a single or two?stage procedures (the combined group) and 32 cases were treated with anterior debridement and strut graft?ing with instrumentation (the anterior group). Trauma index (the operation time, blood loss, the length of hospital stay, compli?cations);imaging parameters (Segment kyphotic angle, corrective rate, loss angle, bone fusion time) and the quality?of?life indi?cators (Oswestry Disability Index、Frankle grade、visual analogue scale、Macnab score) were compared among three groups. Re?sults The mean operation time, mean blood loss and the complications rate were (207.9 ± 30.9) min, (409.5 ± 107.9) ml and 12.95%in the posterior group;(270.7±32.0) min, (649.0±120.0) ml and 30.95%in the anterior group;(349.7±38.9) min, (840.0± 168.7) ml and 25%in the combined group. The operation time, blood loss and the complications rate of the posterior group were less than the anterior group and the combined group, and the difference was significant;The combined group consumed the longest operation time, associated with the most intraoperative blood loss, the highest complication rate and the longest hospital stay among the three groups, and the difference was significant. The correction rate of kyphosis achieved of the anterior group ( 52%± 5.45%) was significantly inferior to the posterior group (74%±5.04%) and the combined group (69%±7.95%), while the loss of cor?rection in the anterior group (2.5°) was higher than both the posterior group (0.8°) and the combined group (1.1°), and the differ?ence was significant. The average follow?up was(6.5±1.96)years (range, 5-11). The mean bone fusion time of the posterior group, the anterior group and the combined group were (6.0±1.5) months, (6.2±1.3) months and (6.5±1.6) months respectively, and there was no statistic difference. After the surgery, the quality of life was improved obviously in all patients. At the time of the latest fol?low?up, the improvement rate of the ODI,VAS and the excellent and good rate according to the Macnab score were 80.6%±2.1%, 81.7%± 1.6%and 95.24%in the posterior group;79.8%± 1.5%, 79.7%± 2.0%and 92.95%in the anterior group;81.3%± 1.1%, 79.9%±0.8%and 90.63%in the combined group. There was no significant difference among the groups in the improvement rates of the ODI, VAS, Frankel grade and the excellent and good rate of the Macnab score. Conclusion The Mid?term follow?up of the different surgical procedures for the treatment of the lumbar tuberculosis in adults were basically satisfactory. Compared with the traditional surgery, the posterior?only surgery is a safe, minimally invasive and effective method in the management of monoseg?ment lumbar tuberculosis in adults.

Objective To explore the role and expression of cell apoptosis regulatory genes in patients with temporal lobe epilepsy characterized by hippocampus sclerosis.Methods The experimental specimens were obtained from 15 patients with temporal lobe epilepsy (epilepsy group) and 6 control samples (control group) were obtained from temporal lobe excision of brain trauma decompression,investigated neuron apoptosis by HE stain,TdT-mediated dUTP-biotin nick end labeling (TUNEL) method,and determined the expression of bcl-2,bax and caspase-3 by immunohistochemistry.Results The evidence of neuron apoptosis was not found by HE stain in both control group and epilepsy group.Positive cells was not found in control group,but was obviously observed in epilepsy group by TUNEL staining [(4.39 ± 2.04) numbers/100].Unlike that in normal adult brain,bcl-2 immunoreactivity was obviously observed in some neurons in epilepsy group[(6.72 ± 3.36) numbers/100] (P ＜ 0.01).Compared with control group,bax protein in epilepsy group was mild expression (P ＞ 0.05).Two cases in control group were detected the expression of caspase-3 protein,and caspase-3 significantly increased in epilepsy group [(1.07 ± 0.43),(9.54 ± 3.68) numbers/100] (P ＜ 0.01).Conclusions Neuron apoptosis is an important cause of hippocampal sclerosis of human epilepsy.bcl-2 and caspase-3 may play an important role in this process.

Objective: To determine the clinical efficacy and feasibility of multiple special formed titanium mesh cages (TMCs) to treat lumbo-sacral spinal tuberculosis via posterior approach. Methods: From July, 2007 to June, 2013, 25 patients with lumbo-sacral spinal tuberculosis underwent one-stage posterior debridement, internal if xation, and interbody fusion using multiple special formed titanium meshes. We compared the parameters as follow: the pre- and post-operative American Spinal Injury Association (ASIA) score, lumbo-sacral angle, the height of intervertebral space, visual analogue scale (VAS), and erythrocyte sedimentation rate (ESR), and observedoperation time, intraoperative blood loss, and time of bone gratf fusion. Results: Operation time ranged from 90 to 180 min, (128±24) min in average. Blood loss in the operation ranged from 100 to 800 mL, (310±125) mL in average. hTe patients were followed up for 24 to 59 months, (43±7) months in average. One patient delayed healing of wound. ASIA score was improved in a certain degree in patients with neurological dysfunctions. hTe lumbo-sacral angle and the height of intervertebral space in the post-operation were signiifcantly higher than those in the pre-operation (P<0.001). VAS was reduced obviously atfer 2 weeks of operation. hTe ESR recovered to the normal level 6 months atfer operation in all the patients. Solid fusion was achieved within 4 to 8 months, 6 months in average. No sinus tract, cerebrospinal meningitis, tuberculosis recurrence and titanium mesh subsidence were found. Conclusion: For lumbo-sacral tuberculosis, multiple special formed titanium mesh cages via posterior approach is safe and effective, which is good to the stability in spine reconstruction.

BACKGROUND:There are few studies concerning estrogen receptorβgene, and its mechanism of regulating the bone metabolism is stil unclear now. OBJECTIVE:To analyze the effect of estrogen receptorβ(ERβ) silencing on the expressions of transforming growth factorβ1 (TGF-β1) and bone morphogenetic protein 2 (BMP-2) in human osteoblasts METHODS:There were three groups:blank control group (hFOB 1.19 uninfected with any retrovirus);negative control group (containing invalid interference fragment ERβ-shRNA-nc);optimal RNAi group (ERβ-shRNA-3). ERβ-shRNA retroviral vectors in the optimal RNAi group were used to transfect human osteoblasts fol owed by resistance screening and cel expansion. MTT assay was used to detect the proliferative activity of ERβ-silenced osteoblasts. Then under estrogen intervention, the stable inhibition rate of ERβwas determined using western blot assay, and the expressions of TGF-β1 and BMP-2 in human osteoblasts after ERβsilencing were detected by RT-PCR technology and western blot assay. RESULTS AND CONCLUSION:Human osteoblasts that were stably transfected by ERβ-shRNA-3 retroviral vector was selected successful y, and ERβsilencing had no significant influence on the cel proliferation (P>0.05). Under the interference of estrogen, the silencing efficiency of ERβprotein was (93.11±0.57)%(P<0.05), and after ERβsilencing, the expressions of TGF-β1 and BMP-2 were increased by (26.65±3.81)%and (16.62±1.71)%at mRNA level, and increased by (23.79±3.76)%and (18.08±3.20)%at protein level (both P<0.05). In conclusion, ERβmay play an important role in bone metabolism by regulating the expressions of TGF-β1 and BMP-2.

Objective To observe the efficacy ofHuayu Kangyou Formula combined with Western medicine for Hp-related peptic ulcer disease;To discuss the mechanism of action.Methods Totally 152 patients were randomly divided into treatment group and control group, 76 cases in each group. Control group was given standard triple therapy, while treatment group was givenHuayu Kangyou Formula based on the standard triple therapy. The treatment lasted for 6 weeks. The clincal symptom scores and gastroscopy were observed to evaluate the therapeutic effect, adverse reactions were recorded, and relapse of ulcer was followed-up.Results The total effective rates of clinical symptoms in the treatment group and the control group were 94.74% (72/76) and 84.21% (64/76), respectively;the excellent rates were 78.95% (60/76) and 55.26% (42/76), respectively;the incidences of adverse reactions were 5.26% (4/76) and 13.16% (10/76), respectively;the relapse rates after 1 year of follow-up visit were 13.63% (6/44) and 41.67% (10/24), respectively, with statistical significant difference between the two groups (P<0.05).ConclusionHuayu Kangyou Formula combined with Western medicine can effectively improve the efficacy of Hp-relative peptic ulcer disease, reduce adverse reaction rate and relapse rate.

Objective To investigate the complications of three-dimensional correction surgery for scoliosis and the corresponding prevention and treatment strategies.Methods From December 2004 to June 2011,727 cases of scoliosis were treated by three-dimensional correction system.There were 245 males and 482 females,aged from 3 to 62 years (average,18.2 years).Coronal Cobb angles ranged from 32° to 142° (average,87.6°),and sagittal Cobb angles ranged from-10° to 75° (average,45°).Results All patients were followed up for 12 to 90 months (average,62.5 months).All patients underwent surgery safely.The coronal correction rate ranged from 55％ to 98％ (average,85.2％),and the sagittal correction rate ranged from 35％ to 67％ (average,47.5％).There were no major complications such as death and nerve injury,but occurrences of other minor complications were 113 times in 102 cases.There were 26 cases of instrumentation-related complication,including 5 cases of pedicle screw loosening,5 cases of broken screw,8 cases of broken rod,3 cases of hook loosening,and 5 cases of pedicle fracture; 14 cases of them occurred early after correction surgery for adult scoliosis.There were 65 cases of correction-related complication,including 36 cases of junctional kyphosis (21 cases of proximal junctional kyphosis,11 cases of which were neuromuscular scoliosis; 15 cases of distal junctional kyphosis,including 4 cases of Marfan syndrome with scoliosis and 6 cases of neuromuscular scoliosis),22 cases of adding-on phenomenon,and 7 cases of flat back.Internal medicine complications included 6 cases of superior mesenteric artery syndrome and 7 cases of pulmonary complications.Operation-related complications included 4 cases of pressure sore and 5 cases of wound infection.Conclusion Accurate procedures of diagnosis and surgery for scoliosis are the key to decrease and prevent the complications.For adult scoliosis,enough instrumentation should be placed at the apical segments to decrease instrumentation-related complications.For neuromuscular scoliosis and Marfan syndrome with scoliosis,appropriate extension of fusion segment can effectively decrease junctional kyphosis.