The level of CD4~+ CD25~+ regulatory T cells was assayed in the peripheral blood from the patients with Graves' disease (GD) by floweytometry.CD4~+ CD25~+ regulatory T cells as a kind of non-specific immune cells appear to have no relationship with thyroid function,however,their lowered number in early GD patients suggests that they seem to play an essential role in the pathogenesis of GD.

OBJECTIVETo explore clinical outcomes of posterior malleolar fractures with medial-extension type through posterioromedial and posteriorlateral incision.

METHODSFrom January 2008 to January 2011,25 patients with posterior malleolar fractures with medial-extension type were treated by hollow lag screw. Among them, 15 patients were treated through posteromedial incision,including 9 males and 6 females,aged from 21 to 67 years old with an average of 48.1 +/- 1.3; there were 5 cases with type A, 6 cases with type B and 4 cases with type C,according to Denis-Weber classification. Ten patients were treated by through posterior-lateral incision,including 6 males and 4 females, aged from 23 to 64 years old with an average of 46.9 +/- 1.5; there were 3 cases with type A, 5 cases with type B and 2 cases with type C,according to Denis-Weber classification. Operation time, blood loss, length of incision, times of X-ray exposure and complications of two groups were recorded and compared, Baird-Jackson effective evaluation were applied for evaluate clinical outcomes.

RESULTSAll patients were followed up from 12 to 49 months with an average of 20.6 months. There were significant differences in operation time, blood loss, times of X-ray exposure and complications between two group (P < 0.05). While there was no obvious meaning in clinical outcomes between two groups (P > 0.05).

CONCLUSIONTreating posterior malleolar fractures with medial-extension type through posteromedial approach can expose and fix fracture under direct vision, has advantages of shorter operation time, less X-ray exposure and blood loss, is a good choice of surgical approach.

Adult ; Aged ; Ankle Fractures ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tarsal Bones ; injuries ; surgery

Objective To investigate the protective effect of isoflurane preconditioning on myocardium against isehemia-reperfusion(I/R)injury and the possible mechanism.Methods Fifty male SD rats weighing 250- 300 g were randomly divided into 5 groups(n=10 each):Ⅰ control group(C);Ⅱ I/R group and 3 isoflurane preconditioning groups with 0.5%(Ⅲ),or 1.0%(Ⅳ)or 2.0% isoflurane(Ⅴ).The animals were anesthetized with intraperitoneal pentobarbital 40 mg?kg~(-1).The hearts were immediately excised and placed in cold K-H solution.The aorta was canuulated and heart retrogradely perfused with K-H solution aerated with 95% O_2 and 5% CO_2 at 37℃ and 10 kPa in a langendorff apparatus.Left ventricular end-diastollc pressure(LVEDP)and left ventrieular systolic pressure(LVSP)were measured from a fluid-filled latex balloon in the left ventricle.The isolated hearts were made globally ischemic for 30 min followed by 60 rain reperfusion in group Ⅱ-Ⅴ.In the 3 isoflurane preconditioning groups the hearts were perfused with K-H solution saturated with 0.5% or 1.0% or 2.0% isoflurane for 15 rain followed by 15 rain washout before ischemia.The cardiac function variables including LVEDP,LVSP dp/dt_(min),dp/dt_(max) and HR were measured after epuilibrium(baseline values),immediately before ischemia,at the end of 30 min ischemia and 60 min reperfusion.The infarct size and cytochrome C level in cytoplasm and mitochondria of myocytes were measured.Results I/R significantly increased LVEDP and decreased LVSP,dp/dt_(min),dp/dt_(max) as compare with control group.Sevoflurane preconditioning significantly attenuated the depression of cardiac function caused by I/R.Only LVEDP was significantly higher during reperfusion period in the 3 sevoflurane preconditioning group than in the control group but there was no significant difference in LVSP,dp/ dt_(min),dp/dt_(max) between control group and the 3 preconditioning groups.The infarct size was significantly smaller in the 3 preconditioning groups than in I/R group.Cytochrome C level was significantly increased in cytoplasm but decreased in mitochondria in I/R group as compared with control group.Sevoflurane preconditioning significantly ameliorated the release of cytochrome C from mitochondria to cytoplasm in the 3 sevoflurane preconditioning group.Conclusion Isoflurane preconditioning can protect the heart against I/R injury by attenuation of the release of cytochrone C from mitochondria to cytoplasm.

0.05),but correlated with age and invasion depth of tumor(P

Objective To investigate the protective effects of propofol preconditioning on myocardium against hypothermia ischemia normothermia reperfusion injury on isolated rat hearts. Methods The Langendorff apparatus was used.Sixty SD rat hearts were divided randomly into 5 groups after 20-minute equilibrium(n=12): control(Con) group,hearts were continually perfused with K-H buffer for 175 min;ischemia/reperfusion(I/R) group,hearts were perfused with K-H buffer for 40 min,then subjected to global ischemia at 27 ℃ for 75 min,and followed reperfusion at 37 ℃ for 60 min;propofol preconditioning group 1(P1),group 2(P2),and group 3(P3),hearts were perfused with K-H buffer including 50,100,and 150 ?mol/L propofol for 10 min and followed reperfusion like I/R group,respectively.Heart rate(HR),left ventricular end-diastolic pressure(LVEDP), left ventricular developed pressure(LVDP) and ?dp/dtmax at the end of equilibration,pre-ischemia and at the end of reperfusion were recorded.The contents of creatine kinase(CK) and lactate dehydrogenase(LDH) in coronary effluent were measured at the end of equilibration and 1,10,20,30,and 60 min during reperfusion.The activity of superoxide dismutase(SOD) and the contents of maleic dialdehyde(MDA) were measured at the end of reperfusion.The area of infarct region was determined at the end of reperfusion. Results HR,LVDP,?dp/dtmax and SOD activity in P2 and P3 group were higher than those in I/R group(P

Cochlear Implantation ; methods ; Fractures, Bone ; surgery ; Humans ; Temporal Bone ; injuries ; surgery ; Temporomandibular Joint ; surgery

OBJECTIVETo explore optimal choice of surgical treatment for subtrochanteric fractures in older children.

METHODSA retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded.

RESULTSAll children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications.

CONCLUSIONFor the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which has advantages of reliable fixation, and less complications.

Adolescent ; Bone Nails ; Child ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

Chemotherapy, Adjuvant ; Humans ; Stomach Neoplasms ; drug therapy

Objective To improve the level of diagnosis and treatment of the traumatic and hemorrhagic shock.Methods 50 cases of patients with sever traumatic and hemorrhagic shock treated in our department between May 2004 and May 2007 were analyzed retrospectively,and their age,shock severity scale,time to hospital after in- jury,operation,fluid resuscitation volume etc were analyzed to show the relationship between the factors and the out- come.Results The rescue success rate was 76%(38 cases),and traumatic mortality was 24%(12 eases).Conclu- sion Shock severity scale and incorreet resuscitation manipulation are the main factors affecting the result of resusci- tation and treatment of traumatic shock,and early surgery can effectively improve the result of severe trauma thera- py.

Objective To detect the genome-wide genetic alterations in central neurocytoma,and to study the pathogensis of central neurocytoma. Methods Comparative genomic hybridization(CGH) analysis was performed in 10 central neurocytomas. Results Chromosomal imbalances were demonstrated in 6 cases.Overrepresentation of genetic material was detected in 4 cases on Chromosome 2p and 10q,and 3 cases on Chromosome 18q. Conclusion(Genetic abnormalities) on Chromosome 2p,10q and 18q may be associated with the pathogenesis of central neurocytoma.