[Objective] To investigate risk factors and the incidence rate of tracheotomy after cervical spinal cord injuries.[Method]A retrospective analysis was done on 1185 cases suffering from cervical spinal cord injuries statistically.The following correlation factors: ages,gender,type of job,reason of injuries,degree of spinal cord injuries,segment of spinal cord injures,nutritional status during therapy were evaluated by Binary Logistic Regression to discover tile influencing factors for tracheotomy.[Result]Totally 99 cases were undergone tracheotomy(male 87 and female 14).The rate of tracheotomy was 8.35%,Ages,degree of spinal cord injuries,segment of spinal cold injuries,reason of injuries had influence to rate of tracheotomy.The other factors were not correlation to tracheotomy.With increasing of age,the rate of tracheotomy was gradually increased.Nobody was undergone tracheotomy in patients who was younger than 20 years old,and the rate of tracheotomy was 38.7% in patients who was older than 60 years old.With aggravating and segment going up of cervical spinal cord injuries,the rate of tracheotomy was gradually increased.The rate of tracheotomy for cervical spinal cord injury at Grade D was 0.5%,While the rate of tracheotomy for cervical spinal cord complete injury was 19.1%.Tile rate of tracheotomy for cervical spinal cord complete injury was 4.3,22.3,21.6 and 32.7% from C7 to C4,while the rate wasn't high in C3 and C2,because most of these patients had died before they was undergone tracheotomy.The rate of tracheotomy was higher in patients who got injuries from fall than other.[Conclusion]Elder,cervical spinal cord severe injuries,high cervical spinal cord injuries was risk factors for tracheotomy.The patients who got cervical spinal cord complete injuries in C3 or higher than C3 need tracheotomy as early as possible.

Objective To investigate the mechanism of high-glucose-induced injury to human peritoneal mesothelial cells(HPMC). Methods (1)The cultured HPMCs were exposed to culture medium containing different concentrations of glucose(1. 5% , 2. 5% , 4. 25% )for 48 hours and 4. 25% mannitol and normal culture medium were as control. Then apoptosis was observed by flow cytometry and caspase-3 activity was measured by ApoAlert?CPP33/Caspase-3 Assay kits. (2) The cultured HPMCs were exposed to 4.25% glucose culture medium containing different concentrations of caspases inhibitor, Z-VAD. fmk (25, 50, 100 ?mol/L) for 48 hours and 4. 25% glucose culture medium containing DMSO was as control. Then apoptosis was observed by flow cytometry and caspase-3 activity was measured by ApoAlert?CPP33/ Caspase-3 Assay kits as well. Results (1) Glucose increased caspase-3 activity in a concentration-dependent manner. Compared to control, caspase-3 activity was significantly higher in 4. 25% glucose group and 2. 5% glucose group, but not significantly different in 1. 5% glucose group and 4. 25% mannitol group. (2) Apoptotic rate of HPMC was significantly lower in Z-VAD. fmk group than that in control. Z-VAD. fmk decreased the number of apoptotic cells in a concentration-dependent manner. Also, caspase-3 activity of HPMC was significantly lower in Z-VAD. fmk group than that in control. Conclutions (1) High-glucose can induce apoptosis and caspase-3 activation of HPMC in a dose-dependent manner. (2) Z-VAD. fmk inhibits high glucose-induced apoptosis of HPMC in a dose-dependent manner. (3)High glucose induces apoptosis of human peritoneal mesothelial cells by caspase-3 activation.

Xiangxi (the western part of Hunan province) Liu's infantile tuina,as one main school of current infantile tuina in China,highlights the compatibility of the specific points of Wujing in children,the idea of treatment by syndrome differentiation,and produces unique efficacy in the treatment of common diseases in children.Exogenous fever in children can be treated with this method with excellent efficacy.Based on the clinical experience and effective cases treated by this tuina school,the authors elaborated the clinical thought and experience from the perspective view of tuina,for the promotion of Xiangxi Liu's infantile tuina in clinic.

Objective - ，，，，，- - - To establish a gas chromatographic method for the determination of trans 1 1 1 4 4 4 hexafluoro 2 ［ - （）］ Methods - （） butene HFO 1366mzz E in workplace air. HFO 1366mzz E in air was directly collected with aluminum foil ， ， ， composite plastic bag separated by dimethylpolysiloxane capillary column detected by flame ionization detector and Results - （） - 3， quantified with external standard method. The linear range of HFO 1366mzz E was 6.82 68 200.00 mg/m with the 3， correlation coefficient of 0.999 9. The detection limit and the lower limit of quantitation were 0.59 and 1.98 mg/m respectively. - - - The recovery rate was within 95.45% 103.05%. The relative standard deviation of within batch precision and between batch - - ， precision were 2.26% 5.07% and 4.09% 6.82% respectively. The samples can be stored at room temperature for at least seven Conclusion ， ， days. This method is simple to use with a wide linear range low detection limit high accuracy and precision and - （） good sample stability. It can be used for the detection of HFO 1366mzz E in the air of workplace

OBJECTIVETo evaluate the outcome of Titanium elastic intramedullary nailing (TEN) for the treatment of displaced midclavicular fractures.

METHODSBetween February 2010 and February 2013, 62 patients with displaced midclavicular fractures were treated by TEN, including 27 males and 35 females with an average age of 37.6 years old ranging from 15 to 67 years. The course of disease was from 1 to 9 days (means 2.7 days). Thirty-nine cases were treated by closed reduction and 23 cases by assistant small incision. Based on OTA (the Orthopaedic Trauma Association classification) classification, 31 cases of simple fractures involved 5 cases of 06-A1,15 cases of 06-A2,11 cases of 06-A3; 31 cases of wedge fractures involved 4 cases of 06-B1,12 cases of 06-B2,15 cases of 06-B3. Postoperative pain relief were evaluated by VAS score,and operation time,fracture healing time were recorded. After 6 weeks and after removing internal fixation shoulder joint function was evaluated by Constant score, and shoulder joint function were assessed by Herscovici score after 6 weeks.

RESULTSExcept 2 cases were lost to follow-up, 2 cases did not remove internal fixation, 3 cases' fractures were nonunion, the remaining 55 patients received follow-up for an average time of 11.4 months. The average preoperative VAS score was 5.20±0.71, and it turned to be 1.550.59 at 3 days after operation. The average operative duration was 40 min (15 to 65 min). The average bone healing time was (2.71±0.54) months (2 to 5 months). No difference about bone healing time was found between simple fractures and wedge fractures,and between the patients treated by closed reduction and assistant small incision. According to Herscovici standard, the shoulder function was excellent in 49 cases, good in 4, fair in 1, and poor in 1. Simple fractures achieved better Constant score than wedge fractures at 6 weeks postoperatively, whereas no difference was found at 4 weeks after fixation removal.

CONCLUSIONTitanium elastic nails (TEN) for treatment of displaced midclavicular fractures has advantages of good clinical effect,rapid pain relief,fast recovery of shoulder joint function. For OTA classification type B patients with comminuted fracture can replace steel to achieve very good effect, but to grasp the appropriate.

Adolescent ; Adult ; Clavicle ; injuries ; surgery ; Female ; Fracture Fixation, Intramedullary ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

Objective To analyze the incidence and possible etiological factors of hyponatremia after acute cervical spinal cord injury (CSCI),and evaluate the effect of severity of CSCI,age,sex and injured segment on hyponatremia.Methods From June 2005 to March 2011,a series of patients with CSCI caused by cervical vertebras trauma were treated in our department.Except patients combined with craniocerebral injury or chronic diseases,other patients were divided into three groups:complete CSCI group,incomplete CSCI group and no neurological disorder group.Concentration of natrium in blood in all patients was analyzed respectively.Results All 102 patients (83 males,19 females) were selected with an average of 45.6years old.There were 23 patients with complete CSCI,60 with incomplete CSCI and 19 with no neurological disorder.Hyponatremia was found in 15 patients in complete CSCI group,23 patients in incomplete CSCI group and 1 patient in no neurological disorder group.The incidence of hyponatremia was significantly different between three groups,among which the complete CSCI group had the highest incidence.Multiple linear regression analysis showed hyponatremia was obviously correlated with the injury degree of spinal cord,but not correlated with the age,sex and injury segment of the patients.Conclusion Hyponatremia is a common complication in patients suffered from CSCI.Although the balance of natrium in blood is very complicated and influenced by many factors,autonomic nerve system and neuroendocrine system dysfunction,and hemodynamic changes after CSCI may play a key role in happening of electrolytical abnormality.

Background Granulocyte colony-stimulating factor(G-CSF)has been reported to have beneficial effect on cardiac dysfunction in post infarction and doxorubicin-induced cardiomyopathy.Objective To investigate the effects of G-CSF on cardiac remodeling in cardiac hypertrophy induced by angiotensin Ⅱ(Ang Ⅱ).Methods Thirty-six male wild type mice(WT)were allocated randomly to receive subcutaneously G-CSF(10 ?g/kg per day, n=9),or Ang Ⅱ(2.88 mg/kg per day,n=9),or Ang Ⅱ plus G-CSF(Ang Ⅱ 2.88 mg/kg+G-CSF 10 ?g/kg,n =9)for 4 weeks with untreated WT(n=9)as controls.Blood pressure and cardiac function were measured. Heart weight/body weight ratio,myocyte cross-sectional area and fibrosis area were determined.The mRNA ex- pression of osteopontin(OPN)in myocardium was detected by RT-PCR.The expressions of angiotensin converting enzyme(ACE),ACE2 and phosph-p70S6 kinase protein in myocardium were assessed by Western-Blot.Results Ang Ⅱ significantly elevated blood pressure(SBP,Ang Ⅱ:139.7?1.6 vs WT:108.7?2.3 mmHg,P0.05),but significantly attenuated the myocyte cross-sectional area(Ang Ⅱ+G-CSF:181.06?0.11 vs Ang Ⅱ:202.02?0.16 ?m~2,P

Objective To construct an expression plasmid carrying the specific siRNA of survivin gene,and to evaluate its silencing effect on the expression of survivin gene and its inhibition effect on the growth of gastric cancer cells.Methods The specific siRNA of survivin gene was designed and synthesized,and an expression plasmid pAdGFP-siRNA was constructed.Gastric cancer cell line SGC-7901 was cuhured and transferred with pAdGFP-siRNA,then the silencing of survivin gene expression and the growth inhibition of cancer cell mediated by pAdGFP-siRNA were identified.Results The growth of gastric cancer cells was inhibited after transferring the pAdGFP-siRNA,with the inhibition rate of 68.2% compared to the control group.Immunohistochemistry showed that the specific siRNA markedly silenced the expression of survivin gene in cancer cells.Conclusions The overexpression of survivin gene in gastric cancer cells results in the high proliferation and the resistance to the chemo- and radio-therapy of the cancer cells.The specific siRNA can markedly silence the expression of survivin gene and inhibit the growth of cancer cells.

Objective To evaluate the efficacy of tibial bone-skin flap grafts in the management of se- vere traumatic osteomyelitis complicated with bone and skin defect in leg to avoid amputation.Methods From March 1998 to Aug.2004,12 cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap graft.The longest flap was 17cm,widethest 10cm, The longest bone flap was 12cm.They were followed up for 0.6 to 5 years.Results All the tibial bone-skin flaps survived completely,2 cases of osteomyelitis recurred.The followed-up,from 0.5 to five years,showed good bone union in all cases,averageing 15 weeks.The infection was under control.The leg function and con- tour were satisfactory.Conclusion The tibial bone-skin flap has the advantages of having distinguished sign of anatomy,highly vascularized,easy to obtain,simply and flexible procedure,improving circulation,short- ens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.

Objective To analyze the incidence and risk factors for regional nodal failure(RNF) and chest wall recurrence(CWR) in T1 or T2 breast cancer patients(median age 44 year-range 26-72) with 1-3 positive axillary nodes treated with postmastectomy radiotherapy limited to the regional nodes.Methods From 1990 to 1999,320 patients were treated with postmastectomy(radical or modified radical) radiother- apy confined to the supraclavicular and internal mammary nodes with a median dose of 50 Gy in 25 fractions over 5 weeks.The median number of nodes examined was 8 (range 1-24).The median lymph nods rate (LNR) was 25% (range 5%-100%).Results The 5-year overall survival rate and disease free survival rate was 89.7% and 83.4%,respectively.The 5-year RNF and CWR was 7.9% and 5.7%,respectively. The 5-year RNF in patients with LNR＜30% and≥30% was 4.4% and 14.0% (P=0.002).The 5-year CWR in the subgroups with LNR＜30% and≥30% was 3.5% and 9.6% (P=0.018).In age≤35 year eld patients with LNR≥30%,the 5-year RNF and CWR was 40.0% and 20.0%.In T2 patients with LNR≥30%,the 5-year RNF and CWR was 15.8% and 12.2%.Age and LNR were independent prognostic factors for RNF+CWR,LNR was the only independent prognostic factor for CWR by multivariate analysis. Conclusions In T1 or T2 breast cancer patients with 1-3 positive axiliary nodes treated with radical or modified radical mastectomy,a relatively high incidence of chest wall recurrence is observed in the subgroup of patients with lymph nods rate of 30% or greater accompanied by a T2 primary tumor or age≤35 years old. Lymph nodes rate is the only significant prognostic factor of chest wall recurrence.For these patients,post- operative lymphatic drainage area and chest wall irradiation should be considered.