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

Ultrasound-based molecular imaging technique is a role in positioning based on the conventional ultrasonic detection technology in combination with the targeted ultrasound contrast agent.It is a new technology to detect the changes of target tissue molecular level in vivo state.This article reviews the principles of ultrasound-based molecular imaging and its application in the evaluations of early inflammatory response,neovascularization,and vulnerable plaque in carotid atherosclerosis.

Objective To evaluate the therapeutic effect of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation for the treatment of lower thoracic disc herniation.Methods From June 2000 to June 2010,36 cases of lower thoracic disc herniation were treated with method of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation,including 23 males and 13 females,with an average of 42 years old(range,22-61 years old).The courses of disease were from 21 days to 69 months,with an average of 22 months.The lesion locations were T10-11 for 12 cases,T11-12 for 15 cases and T12L1 for 9 cases.Each of the patients underwent X-ray and MR examination,31 of them underwent CT scanning.Twenty-five cases were central protrusion type,7 cases were para-central protrusion type,4 cases were lateral protrusionstype.The clinical results were evaluated by Otanni scored system.Results The operative time was 135-220 min,with average of 155 min.The blood loss was 350-800 ml,with average of 460 ml.All patients were successfully operated without neurological symptoms aggravation and accidents.Cerebrospinal fluid leakage occurred in 12 cases,which was treated by continuous suture or dura patch repair.Two cases with giant disc herniation suffered from muscle strength decrease of lower limbs after surgery,which gradually recovered after drug treatment of hormones,dehydration,high-pressure oxygen and nerve nutrients.Postoperative X-ray examinations showed that there were no internal fixation loosening.The followed-up period was 14 days to 48 months,mean 4 months.According to Otani scored system,there were excellent results in 12 cases,good results in 18 cases and poor results in 1 case.The clinical satisfaction rate was 83.3%.Conclusion Posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation is a safe and effective surgical procedure for the treatment of lower thoracic disc herniation.

Objective To investigate the effect of allogeneic bone marrow mesenchymal stem cell transplantation on the cardiac structure and function in rats with acute myocardial infarction. Methods Thirty SD rats were randomly divided into blank group, model group, and stem cells group, 10 rats in each group. The model group received left coronary artery ligation to induce acute myocardial infarction, and the stem cells group received myocardial injection of stem cells after coronary artery ligation. After four weeks, cardiac function and heart tissue pathological changes were observed. Results In the model group, left ventricular end-diastolic volume, left ventricular end-systolic volume and end dias-tolic volume were increased, and left ventricular ejection fraction, left ventricular fractional shortening rate and cardiac output were decreased as compared with the normal group and the stem cells group (P < 0. 05). The results of pathologi-cal examination showed that myocardiac fibers dissolved or even disappeared, and fibric proliferation and sear occurred in the model group; in the stem cells group, the arrangement of myocardiae fibers was in disorder and there were a few pro-liferated fibers and scar compared with the normal group. Conclusion Allogeneic bone marrow mesenchymal stem cell transplantation can improve the cardiac structure and function in rat model of acute myocardial infarction.

Objective To evaluate the possible causes of misdiagnosis of minimal breast carcinoma (MBC). Meth-ods The possible causes of misdiagnosis of 90 cases of MBC confirmed by pathology were retrospective analyzed. Accord-ing to the maximum diameter of the lesion, 90 cases were divided into 0.5-1.0 cm group (n=55) and≤0.5 cm group (n=35). And these two groups were subdivided into correct and misdiagnosed groups. The two-dimensional ultrasound findings were observed by using SIEMENZ S2000, GE vivid7 and GE vivid9 color Doppler ultrasound instruments, and reasons of misdiag-nosis were analyzed. Results There were 32 cases were misdiagnosed in 90 patients with MBC. There was significant differ-ence in boundary of misdiagnosis between diameter 0.5-1.0 cm group and≤0.5 cm group. There were significant differences in boundary and calcification between misdiagnosed group and correct group in diameter 0.5-1.0 cm group (P<0.05). There were also significant differences in A/T ratio and accompanying by multiple benign nodules between misdiagnosed group and correct group in diameter≤0.5 cm group (P<0.05). Conclusion The misdiagnosis in MBC is because of different lesion sizes. The misdiagnosis happens in the maximum diameter of the lesions between 0.5-1.0 cm that showed manifestation of sharp edges, no micro-calcification in sonographic features of benign. The misdiagnosis happens in maximum diameter of le-sions≤0.5 cm that manifested as the aspect A/T ratio<1 and characterized by multiple nodules.

This study was designed to investigate the relationship between the hepatotoxicity of Halothane and altered hepatic calcium homeostasis in enzyme-induced hypoxic rats by means of Ca2+ cytochemistry location and EDX microanalysis combined with micropathological stereology of liver and ultrastructural analysis by computer. The results showed that more calcium precipitated the cytoplasm and mitochondria of liver following Halothane exposure than the controls. Based on the experiments, this alteration appeared to be contributed to the accelerated uptake of Ca2+ by the hepatocytes and lessened to pump out the decreased loaded Ca2+ on the other hand. The release of the reserved Ca2+ was increased by Halothane as compared with controls. These results suggest that a loss of regulation of cellular Ca2+ levels plays an important role in the mechanism of hepatotoxicity by Halothane exposure.

Objective To investigate the effect of posterior operation for thoracolumbar burst fractures combined with dislocation. Methods The study involved 22 patients with thoracolumbar burst fractures combined with dislocation admitted into our hospital from October 2005 to March 2008. There were 17 males and 5 females at age range of 18-56 years. The fractures were located at T12-L2. The fractured vertebrae lost its height by 1/4 to 3/4 of the normal height. The upper vertebral dislocation ex-tent was from 25% to 50%. All operations were accomplished within two weeks after injury. The patients were randomly divided into two groups, ie, Group Ⅰ (implanted with 4 pedicle screws in upper and lower vertebrae adjacent to the fractured vertebrae) and Group Ⅱ (implanted with 6 pedicle screws in 2 upper and 1 lower vertebrae adjacent to the fractured vertebrae). The operation time, volume of blood loss, ky-photic angle, neurological function and Low Back Outcome Score (LBOS) were compared between two groups. Results All patients were followed up for 12-36 months. The duration of operation in Group Ⅱ was longer than Group Ⅰ (P < 0.05), with no increase of intraoperative blood loss. Group ⅡI was su-perior to Group Ⅰ in aspects of correction rate, correction loss and implant failure rate (P < 0.05). There was no statistical difference in aspects of neurological function recovery and low back outcome score be-tween two groups. Conclusion Fixation with three vertebrae and six pedicle screws through posterior approach is an effective, feasible and safe procedure for treatment of thoracolumbar burst fractures com-bined with dislocation.

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 evaluate the correlation of sub-foveal chomidal thickness (SFCT) variation in type 2 diabetic patients with clinically significant diabetic macular edema (CSME) and the related factors using enhanced depth imaging optical coherence tomography technique (EDI-OCT).Methods A total of 40 normal volunteers (group A), 49 type 2 diabetic patients without CSME(group B) and 37 type 2 diabetic patients with CSME (group C) were recruited, including 67 male and 59 female.All study subjects received EDI-OCT examination.The SFCT in A, B and C groups were compared using one-way ANOVA analysis.The correlations between SFCT and duration of diabetes, fasting blood glucose (FBG), glycoseylated hemoglobin HbAlc, low density lipopmtein (LDL), triglyceride (TG), total cholesterol (TC), high density lipopmtein (HDL), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed using logistic regression analysis.Results Average SFCT in group A was (271.49±36.18) μm.Average SFCT in group B was (260.48±35.27) μm, and compared with group A, the difference was not statistically significant (P＞ 0.05).Average SFCT in group C was (227.90±34.73) μm, and compared with group A, the difference was statistically significant (P＜0.01).There was a significant difference of SFCT between groups B and C (P＜0.01).There was no statistically correlation between average SFCT and duration of diabetes, FBG, HbA1c, TG, TC, HDL, creatinine, SBP and DBP (P＞0.05), while a statistically correlation between SFCT and LDL or urinary albumin excretion rate (UAER) was observed in the study (r=-0.609,-0.681, P＜0.01).Conclusions Compared with groups A and B, SFCT in type 2 diabetic patients with CSME was significantly thinner.UAER and LDL levels in type 2 diabetic patients with CSME were negatively correlated with SFCT, that is to say, with the increasing of UAER and LDL levels, SFCT in type 2 diabetic patients with CSME decreased.