Objective:To observe the response and changes of cranial suture to the distraction forces in growing goats.Methods:A custom-made distractor was used for expanding coronal suture of 11 growing goats at the rate of 0.4 mm/day for 8 days.The animals were killed 0,2 and 4 weeks respectively after completion of suture distraction application. X-ray examination was taken and the distracted suture samples were harvested and processed for scanning electron microscopic observation and immunohistochemistry examination of BMP and TGF-? expression. The coronal sutures taken from other undistracted animals were used as the controls. Results:The coronal sutures were separated successfully in distracted goats. 0 and 2 weeks after application of suture distraction, the collagen fiber bundles were strengthened and aligned in the direction of the distraction. Strong expression of BMP and TGF-? were detected in the fibroblast-like cells and the active osteoblasts. 4 weeks after suture distraction, signs of intramembranous ossification were found in the edge areas of the distracted suture, and the positive staining of BMP and TGF-? was still noted in the osteoblasts around the newly formed bone trabeculae. Conclusion:BMP and TGF-? may play important roles in the process of bone formation and remodeling during suture distraction osteogenesis.

A total of 120 patients with Ⅲ/Ⅳ degree hemorrhoids were randomly divided into 3 groups.Self-made drainage(A group),traditional device(B group)and stuffing(C group) were used at the end of operation.The patient postoperative complications and satisfaction were observed and compared.The results showed that postoperative abdominal distension,pain,medical dressing dampness and satisfaction were better in A group than those in B and C groups(all P ＜0.01).Postoperative abdominal distention in B group was lighter than that in C group and medical dressing dampness less in C group than that in B group (all P ＜ 0.01).Thus the self-made drainage device may reduce the levels of postoperative abdominal distension,pain and medical dressing dampness and increase postoperative patient satisfaction.

Objective To explore the chest features of patients with the novel influenza type A H1N1 on HRCT. Methods One hundred and seventy-two chest HRCT examinations on 163 cases with Influenza type A H1N1 (9 cases were reexamed) were retrospectively analyzed using standard pulmonary window and mediastinal window, respectively. HRCT imaging appearances were summarized. Results Ninety-seven cases showed normal on chest HRCT, while the others showed abnormalities of parenchymal and interstitial. Among them, HRCT identified ground-glass opacity in 35 cases (53.0%), centrilobular nodules in 30 cases (45.5%), thickening of intralobular septa in 31 cases (47.0%), intralobular thin reticulation and micro-nodule in 8 cases (12.1%), single-lobular inflammation in 19 cases (28.8%), consolidation of lung(the large consolidation and multiple small consolidations)in 15 cases (22.7%), pulmonary atelectasis in 3 cases (4.5%), and irregular lines in 2 cases (3.0%). Pleurisy was also revealed including 8 cases with right pleurisy, 5 cases with left pleurisy, and 19 cases with bilateral pleurisy. Mediastinal and axillary lymphadenopathy were found in 7 cases, who were spared of pleural effusion. All above abnormalities resolved quickly after anti- virus treatment. Conclusion Parenchymal and interstitial abnormalities, mediastinum and axillary fossa lymphadenopathy, and pleural effusion were the common findings on HRCT in patients with Influenza type A H1N1, which were similar to those of other viral pneumonia.

Background and purpose: Metastatic carcinoma and lymphoma are usually the causes of cervical malignant lymph nodes. This paper was aimed to investigate the different appearances of cervical malignant lymph nodes by 2 dimension and color doppler flow imaging (CDFI) and discuss the role of ultrasenography in diagnosing cervical malignant lymph nodes. Methods: Ninety-nine patients and 40 healthy people were selected as our subjects, among which 54 cases were diagnased as metastatic tumor and 45 cases as lymphoma according to pathology examination. With high frequency transducers, ultrasonography was used to document the shape of cervical lymph nodes, the ratio of long/short axis (L/S), types of echo and hilus of lymph node. CDFI features were also recorded and measured in order to analyze the parameters. Results: Compared with image of normal lymph nodes, the image of cervical malignant lymph nodes showed that the shape tended to be round and the ratio of L/S decreased. In addition, the majority of echo types of malignant lymph nodes was a low level echo and easily became fused. Meanwhile, the image of hilus of lymph node tended to disappear or shift. The lymph node of cases with metastatic tumor was shown to be either calcified or liquefied. The rate of blood flow in the artery was observed to be of high velocity and high resistive index (RI). Between metastatic tumor and lymphoma tumor case, there was significant difference in terms of ultrasonographic and CDFI features. All the above results showed that the features of malignant lymph nodes were significantly different from the normal ones. Conclusion: Ultrasonography could be regarded as one method of evaluating cervical malignant lymph nodes.

Objective To investigate the changes of peripheral blood Foxp3+ regulatory T cell (Treg cell) in patients with ovarian cancer (OC).Methods In 46 patients with OC and 46 normal controls,the percentage of peripheral blood CD4+ Foxp3+ Treg cell was assessed by flow cytometry and Foxp3 mRNA level was detected by real-time quantitative reverse transcription polymerase chain reaction.The level of plasma.transforming growth factor β1 (TGF-ββ 1) was measured by enzyme linked immunosorbent assay.Results The percentages of CD4+ Foxp3+ Treg cell,Foxp3 mRNA and level of plasma TGF-β1 in patients with OC were statistically higher than those in normal controls [(11.42 ± 2.67)％ vs.(8.94 ± 1.98)％,0.59 ± 0.21 vs.0.37 ±0.14,(35 580 ±7274) ng/L vs.(28 610 ±5631) ng/L,P=0.0000].Conclusion The number and/or function of CD4+ Foxp3+ Treg cell in peripheral blood of patients with OC are abnormal,CD4+ Foxp3+Treg cell may participate in the occurrence of OC.

Objective To identify the clinical and imaging characteristics in neonatal refractory purulent meningitis. Methods Clinical data of 70 cases of neonatal purulent meningitis admitted to the neonatal intensive care unit at Children's Hospital of Fudan University from January, 2009 to December, 2014 were reviewed retrospectively. The patients were divided into refractory group (n=28) and non-refractory group (n=42) according to the course of antimicrobial therapy.The clinical and brain MRI characteristics of neonatal refractory purulent meningitis were analyzed. Parameters were compared between the two groups using Chi-square or Fisher's exact tests, and Wilcoxon tests where appropriate. Risk factors of neonatal refractory purulent meningitis were investigated by univariate and multivariate Logistic regression analysis. Results Among the 70 cases, 31(44.3%) were positive for cerebrospinal fluid (CSF)/blood culture. The positive rate was higher in the refractory group than in the non-refractory group [75.0%(21/28) vs 23.8%(10/42),χ2=17.843, P<0.01]. The most common pathogenic bacteria isolated in the refractory group were Escherichia coli [8 cases (38.1%)] and group B streptococci [5 cases (23.8%)]. Compared to the non-refractory group, patients in the refractory group were more likely to have seizure, higher CSF white blood cell count, higher CSF protein concentration and lower CSF glucose concentration [53.6%(15/28) vs 7.1% (3/42), 965.0 (463.0-2 200.0)×106/L vs 116.5 (61.0-327.5)×106/L, 3 221.1(2 354.3-4 633.5) mg/L vs 1 487.6(988.2-1 924.1) mg/L, and 0.2 (0.1-0.8) mmol/L vs 1.5 (1.2-1.8) mmol/L; all P<0.01]. Multivariate Logistic regression analysis showed that seizure, low CSF glucose concentration on admission, and a positive CSF/blood culture result neonatal refractory purulent meningitis (OR=9.6, 95%CI: 1.2-76.0; OR=15.0, 95%CI: 5.6-63.3; and OR=7.3, 95%CI: 1.5-36.0, respectively). Abnormal brain MRI findings, including intracranial extracerebral space abnormality, ventricular dilatation and periventricular white matter injury, were more common in the refractory group [100.0%(28/28) vs 61.9%(26/42), χ2=13.827 totally; 64.3%(18/28) vs 21.4%(9/42), χ2=13.023 for intracranial extracerebral space abnormality; 60.7%(17/28) vs 19.0%(8/42), χ2=12.704 for ventricular dilation and 28.6%(8/28) vs 2.4%(1/42) for periventricular white matter injury; all P <0.01]. Compared with the non-refractory group, the refractory group had a longer hospital stay [(48.0±17.4) d vs (26.0±10.2) d, t=6.016, P<0.01] and more adverse events [67.9%(19/28) vs 31.0%(13/42), χ2=9.220, P=0.002], including hearing impairment and requirement of neurosurgical intervention [14/18 ears vs 10/46 ears (21.7%), χ2=4.292, P=0.038]. There was no death in both groups during hospitalization. Conclusions Neonates with seizure, low CSF glucose concentration and positive CSF/blood culture results are more likely to have refractory purulent meningitis. Brain MRI abnormalities are more common in neonatal refractory purulent meningitis.

Objective To observe the changes of serum potassium concentration in rectal cancer patients from the admission to before the operation,to provide clinical evidence for preventing serum potassium disorder during and after their operation.Methods Monitoring of the changes of serum potassium concentration of 40 cases of rectal cancer patients according to three time points including the first day of admission,before taking of cathartics and the morning before operation.They were divided into different groups according to their age(young,middle age and elderly group),gender(male and female group),diet(normal,decreased slightly and serious decline group) and course(long,middle and short course group) of disease.The serum potassium concentration was observed between each time point of each group and SPSS13.0 statistical software was used to analyze the changes above.Results The mean of all patients' serum potassium concentration was (4.09 ± 0.62) mmol/L on the first day of admission,was (3.83 ± 0.46) mmoL/L before taking of cathartics that was decreased compared to the former and there was significant difference (P ＜ 0.01),it was (3.36 ±0.40) mmol/L on the morning of operation and had significant difference with the above two groups (P ＜ 0.01).It hadn't significant difference between different gender and age groups at different time points (P ＞ 0.05) except between the young group and the elderly group in the morning of the operation (P ＜ 0.05).There were statistically significant differences between the different diet condition and different course at anytime point (P ＜ 0.01).Conclusions The rectal cancer patients were possiblely in hypokalemia before operation,the causes might be relative to the long course of disease,the decreased diet,the aged and infirm,the diet structure change after admission and taking cathartics cleaning intestinal tract.

Objective In order to provide clinical evidence of reducing postoperative complications of procedure for prolapse and hemorrhoids and observe the effects of constipation on postoperative complications of procedure for prolapse and hemorrhoids.Methods One hundred and sixty cases of hemorrhoid were divided into two groups according to whether suffering from constipation:there were eihgty cases who were suffered from constipation in the experimental group and eighty cases who were not suffered from constipation in the control group.All patients' postoperative bleeding,anal edema,stool impaction and satisfaction were observed within 30 days and these data were compared and analysed by using SPSS 13.0 software.Results In the experimental group,the postoperative bleeding incidence was 37.5 ％ (30/80),the anal edema incidence was 31.3 ％ (25/80),the stool impaction inci dence was 8.6％ (7/80),and the patients' satisfaction rate was 88.6％ (71/80).In the control group,the postoperative bleeding incidence was 18.6％ (15/80),the anal edema's incidence was 15.0％ (12/80),the stool impaction incidence was 1.3％ (1/80),and the patients' satisfaction rate was 97.5％ (78/80).All the indexes above were different statistically in the two groups (P ＜ 0.05).Conclusion constipation could increase complications and reduce the degree of satisfaction after procedure for prolapse and hemorrhoids.

BACKGROUND: Monkeys, dogs, pigs, rabbits and other large animals have bean applied previously to prepare animal models of midpelatel suture expansion, but there are high cost, small sample size, difficult to obtain antibodies and other disadvantages, Wistar rats have wide heads to facilitate cavity operation, with low cost and high reproduction rata, as the midpalatal suture model, it is possible to overcome the above deficiencies. OBJECTIVE: To establish a rat model of midpalatal suture expansion, and to supply basement for further relative researches of animal models. METHODS: Twenty Wistar male rats of 5 weeks old, average weight of 65 g, were randomly divided into 2 groups, a experiment and a control, with 10 rats in each group. Rats in experimental group were placed on the expansion appliance, inserting into the diastema between the first and second molars, then stick to molar lingual using light-cured resin for retention. The rats in control group were sham operated, followed by one weak of active expansion. After expansion, the midpalatal sections were observed by X-ray and light microscopy. RESULTS AND CONCLUSION: Maxillary X-ray film showed that midpalatal suture in experimental group was significantly widened, molar lead to cheek. Observed by light microscopy, partial oral side of midpalatal suture in the experimental group was obviously enlarged, mesenchymst ceils were spindle, in the same direction to tension force, Below it, traumatic inflammatory response appeared, with a clear bleeding area. The midpalatal suture expansion model in rats is available, simple and reprodudble.

ObjectiveTo study the appearances and dynamic changes of chest high resolution computed tomography (HRCT) in clinically diagnosed critical influenza A (H1N1) pneumonia.MethodsOne hundred chest HRCT scanning examinations were performed in 36 cases of influenza A (H1N1) pneumonia who were diagnosed by the clinical manifestations in one month.The onset,progress and resolve of pulmonary manifestations were analyzed.Results Chest HRCT was performed in six patients,and small patchy opacity presented in three cases and ground-glass opacities presented in the other three cases within 3 days after onset when the disease was at the initial stage.Multiple larger opacities were visualized in all cases at the progressive stage (3 days later after onset),which included the pure ground-glass opacities (9 cases,25.0％ ),ground-glass opacities accompanied by consolidations (20 cases,55.6％),prominent consolidations (7 cases,19.4％),and accompanied pleural lesions (10,27.8％).The lesions strongly progressed within (8.0± 2.6) d and distinctly absorption in all cases (100.0％,36/36) within (16.0±4.8) d after onset of the disease.The pulmonary interstitial hyperplasia was found in 23 cases (63.9％).Dynamic change types of the lesions include absorption after progression,absorption and progression coexistence then absorption and gradually absorption,andabsorptionafterprogressionwas themajor type(41.7％).ConclusionHRCT could distinctly demonstrate the shape,range and dynamic changes of pulmonary lesions of critical influenza A (H1 N1) pneumonia.