Objective To evaluate the value of spiral CT and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods 25 cases with tibial plateau fractures were examined with plain radiograhs,spiral CT and 3D reconstruction during July,1998 to December,2000.The tibial plateau fractures were classified according to Schatzker′s classification on the X-rays and 3D reconstruction images.On the superior view the tibial plateau fractures were divided into anterior lateral,posterior lateral,anterior medial and posterior medial fractures.Results 3D reconstruction images of 25 plateau fractures were the same as what arthroendoscopy were.25 fractures(including 23 arthroscopic management fractures)were operated under 3D reconstruction guide.No one case was infected.The treatment was valid.Conclusion Spiral CT and 3D reconstruction can offer more accurate classification and complement to new spatial classification of fractures.Also can provide better planning and management for the tibial plateau fractures.

Objective In this study,we investigated the hair cell apoptosis and the molecular mechanisms in age-related hearing IOSS mouse cochlea.Methods All animals were assessed by ABR and DPOAE analysis in both ears.TUNEL(Terminal dexynucleotidyl transferase(TdT)mediated dUTP Nick End Labeling)and PI were used to identify DNA fiagments and caspase-3 activities in hair cells.Results The results showed that the nmf308 mice had progressive hair cell loss along with age.The cochlear OHCs were reduced 5%～10% at 1 month and 100% at 3 month in the basal region.Substantial amounts of TUNEL-postive OHCs nuclei were observed at age of 1 month,and activated caspase-3 labeling OHCs were most obviously observed at age of 2 months.Conclusion These results suggest that DNA single strand break is attributed primarily to apoptosis of cochlear lesion,and activation of caspase-3 at leter stage leads to the hair cell apoptiovs of nuclear condensation in age-related hearing loss mouse cochlea.

Objective To study the recovery of the outer hair cells in the bat cochlea after gentamicin exposure.Methods Bats were injected with a daily dose of gentamicin for 15 consecutive days and bromodeoxyuridine (BrdU)was given from day 16 to day 40 of this recovery phase. Hearing was assessed by overt acoustic behavior and auditory brainstem responses analysis, which was performed one day prior to the first injection and a day after the last injection (day 16). On day 40 animals were sacrificed for detection of cells that could take up BrdU. Results After 15 days of gentamicin treatment, all of the animals were proved to be deafened with significant increases of ABR thresholds,compared with control group. The findings in immunocytochemical stained samples and scanning electron microscopy revealed that BrdU labeled nuclei were observed in the cochlea in all of the deafened animals most commonly in the regions of the first-row and second-row Deiter's cells (DCs) and occasionally in the regions of the third-ruw DCs.Conclusion We suggest that, under sufficient drug and enough time, the bat cochlear supporting cells can directly transdifferentiate into the outer hair cells after aminoglycoside exposure. This transdifferentation process is essential for repair of outer hair cells and recovery of normal function after gentamicin exposure.

Objective To observe the efficacy of ultrasound-guided erector spinae plane (ESP) block on intraoperative and postoperative analgesia in patients undergoing chronic empyema. Methods Sixty patients scheduled for elective decortication of pleural fibreboard under video-assisted thoracoscopic, 35 males and 25 females, aged 30-70 years, falling into ASA physical status Ⅰ or Ⅱ, were randomized into 2 groups: ESP block combined with general anesthesia group (group E) and only general anesthesia group (group G). Patients in group E received ESP block before general anesthesia, while patients in group G received general anesthesia only. All patients received patient controlled intravenous analgesia (PCIA). The thoracic paravertebral space were recorded using ultrasound. Dermatomes of sensory block on midclavicular line were recorded at 20 min after ESP block. The amount of remifentanil, duration of stay in post-anesthesia care unit, the frequency of PCIA pressing, the pain analog scale (VAS) scores during rest and movement at 1, 4, 12, 24, 48 h after operation were recorded. Results Twenty-four patients in group E showed unclear thoracic paravertebral space, dermatomes of sensory block at 20 min after ESP block were 4.9 ± 1.0 on midclavicular line. The consumption of remifentanil and duration of stay in post-anesthesia care unit and the frequency of PCIA pressing in group E were significantly less than that in group G (P ＜ 0.05). The VAS scores at 1, 4, 12, 24 h in group E were lower than those of group G (P ＜ 0.05). Conclusion The ultrasound-guided erector spinae plane block were safe and effective for patients undergoing chronic empyema, and provided satisfactory intraoperative and postoperative analgesia.

Objective To investigate the epidemiology characteristics of spinal cord injury(SCI)in hospital.Methods1264 inpatients with SCI during April 1992～August 2006 were analyzed retrospectively.Results and Conclusion56.1% of the cases were 20～40 years old.Traffic trauma(44.3%)and fall injury(21.8%)were the main causes of SCI.The incidences of affected segments were:cervical segments 31.5%,thoracolumbar 28.1%,and thoracic 21.3%.56.7% were complete injury and 43.3% were incomplete.The most frequent complication of SCI were:urinary tract infection,pressure sore and bladder lithiasis.The expenditure of hospitalization was provided by oneself(52.5%),public medicalcare(33.1%),only 4.1% by hospitalization insurance.

OBJECTIVETo study the concentrations and pharmacokinetics of 6 different kinds of antibiotics in rabbit bile, and evaluate their microbicidal potential.

METHODSThirty-six health rabbits were randomly divided into 6 groups, and each group was 6 rabbits. After anaesthesia, the common bile duct of rabbit was isolated and cumulated with a silicone tube. The rabbits were administered intravenously with the equal-effect dose of antibiotics. Bile (1.5 ml) was collected at different time points after administration, and the concentration of antibiotics of bile was assayed by high performance liquid chromatography. The bile drug concentration-time data were processed by software to figure out the pharmacokinetic parameters such as maximum concentration (C(max)), peak time (T(max)), half-life time (T(1/2)), clearance (CL) and apparent volume of distribution (VD). The bile antibiotics concentration contrasted to the minimum inhibitory concentration (MIC), and attained the bactericidal index (C(max)/MIC) and the time when the drug concentration exceeded the MIC (T(>MIC)).

RESULTSThe C(max) and T1/2 of each antibiotic were as the followings: piperacillin (7 950 ± 3 023) mg/L and (1.97 ± 1.23) h, ceftriaxone (1 104 ± 248) mg/L and (3.14 ± 0.57) h, cefoperazone (5 215 ± 2 225) mg/L and (0.89 ± 0.13) h, meropenem (31.97 ± 12.44) mg/L and (0.36 ± 0.11) h, levofloxacin (66.3 ± 36.9) mg/L and (3.32 ± 2.57) h, metronidazole (28.2 ± 10.2) mg/L and (0.81 ± 0.33) h, respectively. Piperacillin/tazobactam and cefoperazone/sulbactam had the largest bactericidal index and the longest T(>MIC), and their bactericidal indexes were (62.1 ± 23.6) - (993.8 ± 377.9) and (164.8 ± 69.0) - (659.3 ± 275.9), their T(>MIC) were (6.00 ± 2.53) - (8.00 ± 0.00) h and (6.33 ± 1.97) - (8.00 ± 0.00) h. The bactericidal index and T(>MIC) of levofloxacin were the smallest, which were (2.1 ± 1.2) - (8.3 ± 4.6) and (0.54 ± 0.25) - (2.67 ± 1.03) h . Ceftriaxone and meropenem were as the medium, and their bactericidal indexes and T(>MIC) were (4.3 ± 1.0) - (69.2 ± 15.5) , (1.42 ± 0.65) - (8.00 ± 0.00) h and (2.0 ± 0.8) - (1 031.3 ± 401.4) , (0.29 ± 0.10) - (1.83 ± 0.26) h. The bactericidal index of metronidazole to anaerobic ranged from 7.4 to 294.9, and the T(>MIC) ranged from 1.88 to 5.00 h.

CONCLUSIONSThe bile concentrations of six antibiotics all exceed their effective bactericidal concentrations. The concentration-time curves of piperacillin, cefoperazone, meropenem and metronidazole conformed to one-compartment model, and ceftriaxone and levofloxacin are conformed to two-compartment model. Piperacillin/tazobactam and cefoperazone/sulbactam have the largest bactericidal index and the longest T(>MIC), so they can be chosen as the first choice for the therapy of hepatobiliary infection.For the anaerobic, the microbicidal potential of metronidazole is high.

Animals ; Anti-Bacterial Agents ; analysis ; pharmacokinetics ; Bile ; chemistry ; drug effects ; Cefoperazone ; analysis ; pharmacokinetics ; Drug Combinations ; Metronidazole ; analysis ; pharmacokinetics ; Microbial Sensitivity Tests ; Penicillanic Acid ; analogs & derivatives ; analysis ; pharmacokinetics ; Piperacillin ; analysis ; pharmacokinetics ; Rabbits ; Random Allocation ; Sulbactam ; analysis ; pharmacokinetics ; Thienamycins ; analysis ; pharmacokinetics

[ ABSTRACT] AIM:To investigate the depressant effect of FK228 combined with rapamycin on the human breast cancer cell line MCF-7 and MDA-MB-435.METHODS:FK228, a new histone deacetylase inhibitor, and rapamycin, the specific inhibitor of the mammalian target of rapamycin ( mTOR) protein, were used in the study.MCF-7 cells and MDA-MB-435 cells were exposed to different concentrations of FK228 and rapamycin.The inhibitory rate of cell growth was de-termined by SRB assay.Combination index ( CI) was used to evaluate the interaction between FK228 and rapamycin.The expression of the apoptotic proteins, cycle proteins and nucleic acid proteins were detected by Western blotting.The cell cycle was analyzed by flow cytometry.RESULTS: Both FK228 and rapamycin showed growth inhibitory effects on the breast cancer cell lines in a time-and dose-dependent manner.CI of the 2 drugs was less than 1 when the inhibitory rate of the cell growth was 50%effective dose (ED50)~ED70, indicating a synergistic effect.The combination therapy of FK228 with rapamycin increased the apoptotic proteins, and induced the down-regulation of phosphorylated Akt and over-expres-sion of caspase-3 compared with a single use of the drugs.The combination therapy of FK228 with rapamycin reduced the cycle proteins, and the cell cycle was arrested in G2/M.The levels of phosphorylated H2AX and acetylated H3 were ob-viously increased after combination therapy.CONCLUSION:The combination therapy of FK228 with rapamycin inhibits the cell proliferation and increases apoptosis with a synergistic effect, which may become a new trend for treating endometri-al cancer.

Objective:To study the potential effects of intensity modulated radiation therapy (IMRT) on clinical efficacy,oral mucosa reaction and immunological foundation;and to explore the effect of immunological changes on clinical efficacy and oral mucosa reaction in patients with nasopharyngeal carcinoma.Methods:A total of 200 patients with nasopharyngeal carcinoma,who came from First Department of Nasopharyngeal Radiotherapy,the First People's Hospital of Foshan from October 2008 to November 2011,were selected.The patients were treated with nasopharyngeal radiotherapy,and divided into an observation group and a control group (n=100 in each group).The control group underwent common conventional two-dimensional radiotherapy treatment,while the observation group underwent IMRT.The 5-year survival rates and recurrence rates were recorded at follow-up.After the radiotherapy,the oral mucosa in the patients were evaluated by the classification standard of acute radioactive mucositis by American Radiotherapy Oncology Group (RTOG),and the number of T lymphocyte subsets before and after treatment was detected.Results:There were significant difference in non-regional-recurrence survival rate,disease-free survival rate,local recurrence rate between the above 2 groups (all P＜0.05),but no significant difference in the distant metastasis-free survival rate (P＞0.05).The acute oral mucosa reactions of grade 1,2,3,4 in the control group were 8.00％,20.00％,12.00％,7.00％,respectively,and those were 7.00％,22.00％,15.00％,1.00％ respectively.There was no significant difference in the acute response of oral mucosa in grade 1,2 and 3 in the 2 groups (all P＞0.05),but there was significant difference in the grade 4 (P＜0.05).There were significantly difference in CD8+,CD4+/CD8+ and CD4+ T lymphocyte subsets before and after treatment in the above 2 groups (all P＜0.01);there were also significantly difference after treatment between the observation group and the control group (all P＜0.01).Conclusion:In the process of treatment in patients with nasopharyngeal carcinoma,the use of IMRT on the basis of chemotherapy is more effective than the conventional two-dimensional radiotherapy,which can reduce the proportion of grade 4 (severe) acute oral mucosa reaction.It may be related to the protective effect of IMRT on immune function in the patients.

Objective To observe the changes in functional connectivity(FC)of raphe nucleus in patients with first-episode depression complicated with suicidal ideation(SI).Methods Ninety-eight first-episode depression patients were prospectively enrolled and assigned into SI group(n=56)or non SI group(n=42)based on complicated with SI or not,while 47 healthy volunteers were recruited as control group.Resting-state functional MRI was performed.FC between dorsal raphe nucleus(DRN),median raphe nucleus(MRN)and the whole brain were analyzed and compared among 3 groups and between each 2 groups,and the correlations of FC of different brain regions with clinical data of SI group were explored.Results Compared with control group,FC between DRN and left cerebellum and left putamen in SI group and non SI group decreased(all P＜0.05),between MRN and right inferior temporal gyrus increased but between MRN and left inferior frontal gyrus,right superior occipital gyrus,left inferior parietal lobule,left putamen decreased(all P＜0.05).FC between DRN and left putamen in SI group was higher than that in non SI group(P＜0.05).FC between MRN and right central posterior gyrus of SI group increased compared with that in the rest 2 groups(both P＜0.05).FC between MRN and left putamen in SI group was positively correlated with body mass score of Hamilton depression scale-24(HAMD-24)(rs=0.297,P=0.026).Conclusion Abnormal changes of FC between raphe nucleus and cortex,also between raphe nucleus and subcortical area occurred,and FC between MRN and left putamen positively correlated with body mass score of HAMD-24 in patients with first-episode depression complicated with SI.

Objective:To investigate the abnormalities of gray matter volume (GMV) and the synergistic changes in different cerebral regions in the first-episode and early-onset depression (EOD) patients.Methods:A total of 60 patients with untreated EOD (EOD group) and 64 healthy controls (control group) matched for age, gender, and education underwent high-resolution T 1WI MR scans. Voxel-based morphometry was used to calculate the cerebral GMV. The difference in GMV between the two groups was compared with the t-test. Different brain regions were selected as seeds for structural covariation network (SCN) analysis. Spearman correlation model was used to analyze the correlation between the GMV in different cerebral regions and illness duration as well as the scores of Hamilton rating scale for depression (HAMD) 17 items in EOD group. Results:Compared to control group, the EOD group had significantly increased GMV in the right orbitofrontal cortex, right dorsolateral prefrontal cortex, right inferior parietal lobule, right superior parietal lobule and bilateral precuneus ( P<0.05, corrected by FDR). Based on the right orbitofrontal cortex and dorsolateral prefrontal cortex as seed regions, structural covariance analysis revealed that abnormal cooperative brain regions in EOD group, mainly distributed in the bilateral frontal lobe, parietal lobe, occipital lobe, temporal lobe, paralimbic system and cerebellum ( P<0.05, corrected by FDR). In EOD group, significant negative correlations were observed between the GMV in the right orbitofrontal cortex ( r=-0.314, P=0.015), the left precuneus ( r=-0.283, P=0.029), and illness duration. Significant positive correlations were observed between the GMV in the right dorsolateral prefrontal cortex and the scores of anxiety/somatization factor of HAMD17 ( r=0.331, P=0.010), the left precuneus and weight factor of HAMD17 ( r=0.255, P=0.049), respectively. Conclusions:Abnormal GMV changes are observed in some regions of the prefrontal and parietal lobule in patients with untreated EOD, accompanied by extensive covariant brain regions and additional structural connectivity. In addition, the abnormal GMV changes in some regions are associated with clinical features. Part of the prefrontal and parietal lobule may be the biomarkers to objectively evaluate abnormal brain structure in depression patients in the early stage.