10.3969/j.issn.1000-3606.2013.06.013

Objective To identify the arteriographic manifestations of emergency uterine artery angiography and the efficacy of embolization treatment of postcesarean massive hemorrhage caused by placenta previa.Methods Emergency uterine artery angiogra-phy was performed in 35 patients with massive hemorrhage after cesarean section due to placenta previa.Emergency uterine arterial embolization (EUAE)was conducted using embolic agents such as tricacryl gelatin microsphere (TAGM)and gelatin sponge.Arte-riographic manifestations and effect of the emolotherapy were analyzed retrospectively.Results Contrast extravasations were con-firmed in 27 patients,and uterine artery pseudoaneurysms were in 8.The hemorrhage completely stopped after embolotherapy in all patients.A 12 month follow-up showed no recurrence hemorrhage and any severe complications were observed in all patients,such as necrosis of the uterus and ovary.Conclusion EUAE can be used as a safe,effective and minimally invasive therapeutic option for postcesarean massive hemorrhage caused by placenta previa.It is the key for the success of embolotherapy to choice and use reasona-ble embolic agents.

Objective To investigate the causes of coma children in Pediatric Intensive Care Unit (PICU).Methods The causes of 210 children with coma were retrospectively analyzed.Results Among 210 cases,150 cases attributed to medical disease (71.43 ％),while 60 cases attributed to surgical disease (28.57 ％).110 cases were caused by infection(52.38％),58 cases were caused by cranioeerebral trauma (27.62％),while 31 cases involved in traffic accident(14.76％).Conclusion The main cause of coma in PICU is infectious diseases,but traffic accident trauma coma has been increased.It is positive to correct treatment and improve prognosis to recognize the cause as soon as possible.

BACKGROUND:Matrix metaloproteinases are now generaly considered to be able to degrade al extracelular matrices. Hypersecretion of matrix metaloproteinases or reduction in tissue inhibitors of matrix metaloproteinases leads to destruction of the dynamic balance of extracelular matrix. OBJECTIVE: To elucidate the role of matrix metaloproteinase-1 and tissue inhibitor of matrix metaloproteinase-1 in the pathogenesis and progression of intervertebral disc degeneration. METHODS:A total of 60 patients with intervertebral disc degeneration were included. Mild, moderate, and severe degeneration signals appeared on MRI imaging of the patients. Meanwhile, 20 patients with vertebral fracture, mainly cervical spine fracture, were selected as the control group. Venous blood samples were colected before the surgery; the intervertebral disc specimens were sequentialy colected. RESULTS AND CONCLUSION: Serum and tissue levels of matrix metaloproteinase-1 in patients with intervertebral disc degeneration were significantly increased compared with the control group (P < 0.05), and furthermore those were significantly increased in patients with severe disc degeneration compared with patients with mild and moderate disc degeneration (P < 0.05). However, serum and tissue levels of tissue inhibitors of matrix metaloproteinases did not differ significantly between the disc degeneration and control groups (P > 0.05). These results indicate that hypersecretion of matrix metaloproteinase-1 occurs in patients with intervertebral disc degeneration; however, the expression of tissue inhibitor of matrix metaloproteinase-1 is not correlated with intervertebral disc degeneration.

The nuclear factor erythroid 2 related factor 2 (Nrf2) is a key protein of endogenous antioxidant defense systems in the body. In response to oxidative stress, Nrf2 translocates to nucleus and binds to antioxidant response elements (ARE), regulating the expression of a large amounts of antioxidant genes and maintaining a proper redox balance. The pathological processes of neurodegenerative diseases are associated with generation of reactive oxygen species, which cause oxidative stress. Oxidative stress plays a cardinal role in the onset and progression of neurodegenerative diseases. Nrf2-inducer compounds can reduce oxidant stress and have shown therapeutic efficacy in many neurodegenerative disease models. How to activate the Nrf2 signaling pathway effectively has been received much attention. Here we provided an overview of specific mechanism of Nrf2-ARE pathway and the protective effects of Nrf2 in different neurodegenerative diseases, and summarized the Nrf2 activators recently in preclinical study.

ObjectiveTo investigate the role of apoptosis played in myocardial hypertrophy and the effect of L-arginine (L-Arg) on the pathogenesis.Methods36 rats were randomly divided into the control group, model group and L-Arg treating group. The animal model of over-loading myocardial hypertrophy was made, and systolic blood pressure (SBP)and the cardiac indexes were measured, spectrophotography and flow cytometry were used to detect the content of nitric oxide (NO), activity of superoxide dismutase (SOD) and apoptosis rate.ResultsIn the model group, SBP, cardiac indexes and myocardial apoptosis rate increased, the content of NO and activity of SOD decreased compared with the control group. While, in the L-Arg treating group, SBP, cardiac indexes and apoptosis rate decreased, the content of NO and the activity of SOD increased compared with the model group.ConclusionMyocardial apoptosis may play an important role in the pathogenesis of myocardial hypertrophy and cause the losing of myocardial cells. L-Arg induces the increasing production of NO and inhibits myocardial apoptosis through increasing the activity of SOD.

Objective To study the role of psychological factors in the onset of psoriasis,to investigate the role of monoamine substances in the course of psychological factors-associated psoriasis,and to reveal the psychoneurologic pathogenesis of psoriasis.Methods The psychological factors were assessed with life events scale and questionnaire of A character.The serum levels of norepinephrine(NE),dopamine(DA)and5-hydroxyindoleacetic acid(5-HIAA)were detected with high-performance liquid chromatography(HPLC).Results It was shown that there was an overall tendency of weak A character and moderate depression and anxiety in psoriasis patients.The concentrations of NE,DA and5-HIAA were higher in psoriatic patients than those in normal controls(P

BACKGROUND:Destroying posterior stable structure of cervical vertebra may facilitate the ligamentum flavum regeneration. Whether anterior cervical instability can induce the regeneration in posterior and adjacent ligamentum flavum remains unclear.
OBJECTIVE:To observe the changes of transforming growth factor-β1 expression and histopathology in the ligamentum flavum of cervical instability animal models.
METHODS:Thirty-six New Zealand white rabbits were randomly divided into control group and experimental group, with 18 rabbits in each group. In the experimental group, cervical instability animal models were established made through destroying annulus fibrosus by anterior puncture and absorbing nucleus pulposus in C4/5 . And no intervention was given to the control group.
RESULTS AND CONCLUSION:Compared with the control group, fibers in the C 3/4, 4/5, 5/6 ligamentum flavum arranged disorderly and the glass like degeneration was found in the experimental group. The expression of transforming growth factor-β1 in ligamentum flavum was increased, especial y in C 4/5 , in the experimental group. At 4, 8, 12 weeks, transforming growth factor-β1 expression in the C 3/4, 4/5, 5/6 ligamentum flavum segments was similar between the two groups. Experimental findings indicate that, anterior cervical instability can induce the regeneration in posterior ligamentum flavum, especial y in the injured segment.

Objective To identify risk factors for wound complications related to internal fixation of distal tibial fracture.Methods A total of 125 patients undergone open reduction and internal fixation of the distal tibial fracture between January 2008 and December 2011 were enrolled.There were 72 men and 53 women with mean age of 41.46 years.Factors contributing to operative wound complications assessed were demographic characteristics (age,gender,and smoking history),types of fracture,operative time,time from injury to operation,and concomitant diseases (diabetes and peripheral vascular disease).Patients with wound complications were defined as those requiring dressing care and oral or intravenous antibiotics or those requiring further surgical treatment.Results At follow-up,wound complications were recorded including 1 patient (0.8％) had surgical debridement and 10 patients (8.0％) had dressing care and oral or intravenous antibiotic therapy.Logistic regression analysis identified risk factors for wound complications were open fracture (OR =23.077,95％ CI 2.672-199.342,P ＜0.01) and age (OR =1.078,95％ CI 1.011-1.150,P ＜ 0.05).Otherwise,following factors exhibited no significant correlation with wound complications:age,body mass index,smoking history,types of fracture,multiple injury or not,and operative time.Conclusion Patients with older age or open fracture present an increased risk of wound complications after operation and need special concern.

The vast majority of vertebral compression fractures are caused by osteoporosis and vertebral tumor,which lead to the pain of a fracture and intervertebral height lost.In recent 20 years,the use of percutaneous vertebroplasty and percutaneous kyphoplasty,a kind of minimally invasive surgery method intended for the vertebral compression fractures,are rising up for patients with vertebral compression fractures,which can quickly relieve patients' pain and restore injured vertebral deformities.Percutaneous vertebroplasty injects bone cement into fractures through a small incision.However,percutaneous kyphoplasty injects a balloon into a fracture to make a cavity by expending and shrinking,which is filled with filler material,and then removes the balloon,and injects bone cement.This article mainly reviews development,curative effect and safety,clinical application and future aspects.of the percutaneous vertebroplasty and percutaneous kyphoplasty.