Objective To evaluate the protective effect of inhaled nitric oxide(NO) on newborn piglets with asphyxia-induced myocardial impairment. Methods Twenty-nine newborn piglets were divided into three groups: (1)control group(CON,n =8); (2)asphyxia without NO inhaled group(ASP,n =11); (3)asphyxia with NO inhaled group (INO,n =10). In both ASP and INO group,asphyxia was induced by clamping the inhalation tube for 10min. After cardiopulmonary resuscitation (CPR),both groups were mechanically ventilated with 35% of O 2 for 6 hrs,but 10ppm of nitric oxide was applied additionally to INO group. Mean pulmonary artery pressure (mPAP) was monitored continuously. Serum creatine kinase,MB (CK-MB),and cardiac troponin T (cTnT) were measured at 6h after CPR. Cardiac functions were evaluated at 6h after CPR by echocardiography including left ventricular ejection fraction (LVEF),right ventricular ejection fraction (RVEF),ratio of peak E velocity and peak A velocity of mitrial flow and tricuspid flow (ME/A and TE/A),ratio of peak e velocity and velocity of mitral annulus motion and tricuspid annulus motion (Me/a and Te/a). The CON group was examined correspondingly. The myocardial histopathologic damage score (MHDS) was used to evaluate the severity of myocardial impairment. Results During 1 h to 6 h after CPR,INO group displayed a lower level of mPAP (14?6)～(12?4) mm Hg when compared with ASP group(23?5)～(19?3) mm Hg ( P

Objective To discuss the clinical characteristics and treatment of upper cervical spine injuries in the elderly. Methods A retrospective study was done on clinical data of 28 elderly patients ( > 60 years old) with upper cervical spine injuries treated from January 2003 to December 2007. There were 20 males and 8 females, at age range of 60-86 years (mean 68.1 years). Injury causes included slip in 16 patients, traffic injury in eight and fall from height in four. Atlas fractures occurred in five patients and axis ones in 15,of which there were eight patients with odontoid fractures, six with C2 vertebral arch fractures and one with C2 body fractures. Upper cervical spine injury was combined with lower cervical spine injuries in five patients. There were combined atlantoaxial injuries including odontoid fractures combined with lateral atlas fracture in one and edontoid fractures combined with anterior atlas arch fracture in one. Atlantoaxial dislocation occurred in one patient and combined spinal injury in four. Of all, eight patients were treated conservatively, eight with open surgical operation and 12 with minimally invasive surgery. Results The average hospital stay was 16.5 days, with no statistical difference be-tween conservative treatment group and open surgical operation group ( P > 0.05 ). While the average hos-pital stay in minimally invasive surgery group was shorter than that in conservative treatment and open sur-gical operation groups ( P < 0.05 ). Of all, two patients in conservative treatment group and one in open surgical operation group died and the other 25 patients were followed up for average 16.8 months (9-56 months). The satisfaction rate was 50% in conservative treatment group, 72% in open surgical operation group and 75% in minimally invasive surgery group. Complications occurred in four patients in conserva-tive treatment group, three in open surgical operation group and two in minimally invasive surgery group. Conclusions With odontoid fracture the most common injury type, upper cervical spine injuries arema-inly caused by low-energy force and characterized by low mobidity of spinal cord injuries and high possi-bility of missed diagnosis in the elderly patients. The surgical treatment especially minimally invasive surgery can bring good results compared with conservative methods.

Objective To explore different treatment choices for unilateral cervical facet locking. Methods The study involved 32 patients with cervical unilateral facet locking. Successful reduction by the skull traction was done in eight patients, of whom three were fixated by the head and neck chest plas-ter after a month of traction. Five patients were treated with anterior decompression and internal fusion fixation. The other 23 patients resulted in failure of traction and then were treated with anterior reduction, discectomy and internal fusion fixation in 14 patients, subtotal vertebral decompression and bone graft fix-ation in three, posterior open reduction and anterior bone graft fixation in one, posterior reduction, fixation and internal fusion fixation in three and posterior reduction and decompression plus anterior discectomy decompression and bone graft fixation in two. Due to misdiagnosis, one patient was treated with anterior decompression and fusion eight months after injury. Results A follow-up for average 18 months showed cervical instability in two patients who were treated with only traction, without fusion. The patients treated with anterior cervical fusion obtained bone union after 12 weeks, with satisfactory cervical physiological curvature and vertebral height. There were no internal fixation complications or neurological complications. Conclusions The treatment of lower cervical unilateral facet locking needs a compre-hensive considerations on whether there associates with disc injury, posterior column fractures or spinal cord injuries. As for patients with lower cervical unilateral facet locking combined with traumatic cervical disc herniation, the anterior reduction and decompression is the choice of treatment. While for those with-out disc herniation, traction or posterior open reduction and fixation can be carried out directly.

Objective To evaluate the mid-term clinical effects and the imaging changes of Coflex interspinous dynamic internal fixation for low back pain. Methods From February 2007 to June 2009,Coflex interspinous dynamic internal fixation was performed in a consecutive 45 patients. They included 26 males and 19 females, with an average of 51.4 years ranging in age from 45 to 70 years. Thirty-two cases were in L4.5 level, 11 in L5S1 level and 2 in both two levels. The patients were treated with limited laminectomy and implanted with Coflex device. Clinical outcomes were assessed by Oswestry disability index (ODI)scores and Japanese Orthopaedic Association (JOA) questionnaires before and after operation. The imaging examination was obtained to assess height of the intervertebral space, area of the intervertebral foramen,segment movement of the operation level, low lumbar curvature and signal of the lumbar disc on MRI. Results The follow-up time ranged from 10 to 34 months, with an average of 24 months. The ODI scores decreased significantly from 62.82±10.42 preoperatively to 11.80±3.35 postoperatively. The JOA scores were improved remarkably from 9.00±2.63 preoperatively to 24.65±1.86 postoperatively. The proportion with optimal effect was 89% (40 cases). The Cobb angle after operation of L4.5 and L5S1 level was 15.1°±3.9° and 16.3°±3.8° respectively, which was significantly decreased after operation. The range of motion of the L4.5 level increased from 6.5°±1.5° to 8.4°±2.6° while the L5S1 level did not change notedly. The heights of the dorsal intervertebral disc, distance of the spinous processes, intervertebral foramen height and area were significantly higher than those before operation. Conclusion The Coflex interspinous dynamic internal fixation is available to reserve segment movement, to increase intervertebral space height and foramen area. Meanwhile,it is effective to self-repair and prevent degeneration for the disc in adjacent levels.

Objective To study the neuroprotective role of TFP5 in a MPTP-induced mouse model of Parkinson's disease (PD).Methods C57BL/6 mice were used as experimental animals.Briefly, 5 consecutive days of intraperitoneal injection of 25 mg/Kg 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was applied to induce mouse PD model.The mice were randomized into 5 groups including control group,model group, scrambled TFP5 peptide (Scb) group, TFP5 group and roscovitine group.On the 7th day after the first injection of MPTP,behavior tests were performed, and then western blot method was employed to detect the expression of p25 and phosphorylated MEF2D in substantia nigra.Tyrosine hydroxylase (TH) immunohistochemical staining was performed to observe the apoptosis of dopaminergic neurons in substantia nigra pars compacta (SNpc) 28 days after the first injection of MPTP.Results MPTP increased the expression of p25 (0.48±0.10 vs 0.26±0.02, P＜0.05) and phosphorylated MEF2D (0.81±0.10 vs 0.22±0.02, P＜0.05) in substantia nigra, but decreased the number of dopaminergic neurons in SNpc (348.67±24.40 vs 463.29± 19.61, P＜0.05),resulting in motor impairment in the model mice (P＜0.05).Intraperitoneal injection of 30mg/Kg of TFP5 for 3 days effectively reduced the excessive phosphorylation of MEF2D (0.25 ± 0.12 vs 0.81 ± 0.10, P＜ 0.05) in substantia nigra, rescued dopaminergic neuron reduction of SNpc (422.92±8.41 vs 348.67±24.40, P＜0.05), and improved the motor ability of the model mice (P ＜0.05).Roscovitine exerted almost same neuroprotective role as TFP5 ,while Scb had no protective effect.Conclusion TFP5 can rescue MPTP-induced damage of dopaminergic neurons in substantia nigra, and thus improve motor impairment of model mice,which may be mediated by the inhibition of Cdk5/p25 activity.

Aim To explore the effect of genetic poly-morphisms of POR on the stable warfarin maintenance doses in Han Chinese patients receiving mechanical heart valve replacement. Methods The association between POR gene polymorphisms and warfarin doses of 185 Han Chinese patients were investigated through ANOVA or t test. SNPs of POR and VKORC1 were de-tected by Sequenom? DNA MassArray genotyping method. CYP2C9*3 was genotyped by polymerase chain reaction-restriction fragment length polymorphism method ( PCR-RFLP ) . Patients ’ clinical characteris-tics, INR value and daily dose were obtained from their medical records. Statistical analysis was performed by SPSS 21. 0 software. Results No mutant carriers of POR rs17148944 , POR rs56256515 and rs72553971 were found in this study. The genotype frequencies of other SNPs were in accordance with Hardy-Weinberg e-quilibrium. In the group of patients with CYP2C9*1*1 , the mutant type carriers ( T carriers ) of POR rs17685 had a significantly higher dose than CC carri-ers(3. 50 ± 1. 07) mg·d-1 vs (3. 14 ± 0. 94) mg· d-1,P =0. 03. Also, in the group of patients with CYP2 C9*1*1 and VKORC1 rs9934438 G allele carri-ers, the mutant type carriers ( T carriers ) of POR rs17685 had a significantly higher dose than CC carri-ers(4. 76 ± 0. 90) mg·d-1 vs (4. 08 ± 1. 03) mg· d-1 ,P=0. 04. No significant difference was found in different genotypes of POR rs2868177 . Conclusion These results illustrate that POR rs17685 T carrier is closely associated with a higher warfarin maintenance dose, suggesting that this SNP is useful for clinical guidance of warfarin.

[Objective] To optimize the conditions of the extracting process of Hujin Granules. [Methods] The orthogonal design was applied. With the total emodin and the total anthraquinone (TA) content as the parameters for the alcohol-extraction, the concentration of alcohol, the volume of solvent and the extracting time were used for optimization of alcohol-extraction. With the total polysaccharide (TP) as the parameters for water-extraction, the soaking time, the volume of water and the extracting time were used for optimization of water-extraction. [Results] The optimum conditions of alcohol-extraction were: extracting with 70% alcohol 245 mL for 2 hours and extracting twice. The optimum conditions of water-extraction were: extracting with 80 mL water (not for soaking) for 1.5 hours, extracting 3 times. [Conclusion] The results indicate that the extracting process is rational and feasible, and can provide evidence for the extracting process of Hujin Granules.

Objective To investigate complications associated with Coflex interspinous process device for degenerative lumbar disc diseases and methods to treat.Methods Clinical data of 121 patients with degenerative lumbar disc diseases,who had undergone surgical decompression and additional fixation of Coflex between November 2007 and June 2011,was analyzed retrospectively.There were 76 males and 45 females,aged from 37 to 75 years (average,54.6 years).Surgery-related complications and sequelae were recorded and analyzed.Results Surgery-related complications occurred in 10 patients,and the incidence was 8.3％ (10/121).There were 3 cases of device-related complications,including wing break in 1 case,prosthetic loosening in 1 case and spinal process fracture in 1 case; all 3 cases were treated conservatively and received good results.There were 7 cases of non-device-related complications,including dura mater dilaceration in 2 cases,superficial wound infection in 1 case,insufficient decompression of spinal canal in 2 cases,recurrence of disc herniation in 1 case,and intraspinal hematoma in 1 case; the former 3 patients recovered after corresponding treatment,and the latter 4 patients also recovered after re-operation.Conclusion The incidences of complications and re-operation associated with application of Coflex are low,and the incidence of device-related complications is also low.The precise intraoperative manipulation is the key to reduce incidence of device-related complications.It's absolutely necessary to strictly master surgical indications and perform sufficient decompression in order to receive good surgical results and avoid non-device-related complications.

Objective:To ascertain the basic situation of radiotherapy in Fujian in 2016.Methods:Based on the unified questionnaire, the types and quantity of radiotherapy and its corollary equipment, the number of radiotherapy staff and the work for quality control were surveyed in the radiotherapy units in the whole province, and the data on patients undergoing radiotherapy and other types of patients were collected from 26 hospitals. The total number of radiotherapy patients in the whole province was estimated by the correlation analysis and multiple linear regression analysis.Results:Radiotherapy was performed in a total of 32 hospitals in Fujian province in 2016. Among them, there were 62 sets of radiotherapy equipment, 33 sets of the simulators, 57 sets of treatment planning systems and 762 workers. The total number of 15 156 radiotherapy patients in 26 hospital were available for the survey. Multiple linear regression models showed that the frequency of application of medical electron accelerator was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of electron accelerators ( r=0.311, 0.893, 0.956, P<0.05). Meanwhile, the frequency of aterloading brachytherapy was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of aterloading brachytherapy units ( r=0.307, 0.966, 0.988, P<0.05). The frequency of radiotherapy was 0.54 patients per 1 000 population in Fujian in 2016. The delivered dose calibration of accelerators was performed in all hospitals involved in line with the relevant regulations, but the number of quality control equipment for radiotherapy was insufficient, such as the QA beam checker or well-type ionization chamber. Conclusions:In recent years, the rapid development of radiotherapy has been seen in Fujian province. The radiotherapy management should focus on standardenized and improved quality control and regulation in future.

Objective:To investigate the differences in applicability of both the portable high-purity germanium (HPGe) γ spectrometer and the portable lanthanum bromide (LaBr) γ spectrometer for measuring thyroid 131I activity and internal exposure monitoring for radiation workers. Method:Both DETECTIVE-DX100-KT portable HPGe γ spectrometer and InSpector 1000 portable LaBr γ spectrometer were used to measure the 131I content in thyroid of radiation workers for comparison of the measuring result, minimum detectable activity (MDA) and corresponding annual committed effective doses between two types of spectrometers. Results:The detection rate of 131I in thyroid of radiation workers was 67.7% for HPGe γ spectrometer and 26.2% for LaBr γ spectrometer, respectively. The MDA was 12.26-14.74 Bq (measuring time: 3-5 min) for HPGe γ spectrometer and 56.56-80.37 Bq for LaBr γ spectrometer (measuring time: 2-4 min). The annual committed effective dose corresponding to MDA was 0.07-0.08 mSv (3-5 min) for HPGe and 0.31-0.45 mSv (2-4 min) for LaBr, respectively, in the case of using chronic continuous intake mode and 7 d monitoring period. Conclusions:The minimum detectable activity (MDA) of the two types of portable spectrometers could meet the requirements specified in GBZ 129-2016 Specifications for individual monitoring of occupational internal exposure for thyroid monitoring equipment. The two types of spectrometers could be used for routine monitoring of internal contamination. The difference between the monitoring result of LaBr γ and HPGe γ spectrometers might be due to such factors as large uncertainty in short measuring time and low activity concentrations, incomplete identical of distance between probe and neck, probe angle setting, different response of equipment to the environment, background deduction method.