Objective: To observe the changes of blood T-cell subpopulations, ASO,IL-6 and IL-8 in children with Tic disorder and explore the pathogenesis. Methods: T-cell subpopulations and concentration of IL-6, IL-8, ASO were measured in 52 children with tic disorder and 30 normal children using SAP and ELISA.Results:The numbers of CD3+、CD4+ and CD8+ cells had no significant difference between 32 children with tic disorder and 30 normal children, and the concentration of ASO in serum of children with tic disorder was markedly higher than those in normal children. The concentrations of IL-6 and IL-8 in serum had no significant difference between the two groups.Conclusion: There may be dysfunction in humoral immunity in tic disorder.

Objective To evaluate the intensity-modulated radiation therapy(IMRT)for the whole pelvis in the treatment for cervix cancer with the method of ionization chamber verification and fluence map verification.Methods IMRT plan was designed with Pinnacle 7.0 inversed treatment planning system,and the planning parameter was copied to the solid water phantom.The dose of the reference points in the phantom was calibrated with ionization chamber,and compared with those in IMRT plan.Then the gantry angle was set as 0 degree.The solid water phantom was irradiated with film,and the actual fluence maps were obtained 2cm below the phantom surface,and then the delivered films were compared with those fluence maps in plan.Results The error percentage at 4 points was less than 3% in absolute dose calibration,at 2 points was less than 5%,at another 2 points was less than 5%,at 1 point was over 10%,and at another 1 point was over 15%.It was found that the last two calibrated points were set in a region with a high dose gradient,resulting in high error.In fact they were impertinent.So another two points were chosen in uniformity area of dose distribution.The percentage of error were both less than 3%.The fluence maps between films and plan were consistent.Conclusion It is feasible to evaluate IMRT plan for whole pelvis in the treatment of cervix cancer with the method of ionization chamber verification and fluence map verification.The results can meet the clinical requirement.

BACKGROUND: Negative pressure of limbs is a convenient, safe and unwound way to treat peripheral arterial occlusion and to relieve pain.Prostaglandin E1 can directly rellax vascular smooth muscles and relieve pain on nerve.OBJECTIVE: To observe the effect of negative pressure of limbs immunologic reaction positive nerve fiber of prostaglandin E1 in sensory nerve fiber of central nervous system of dogs with peripheral arterial occlusion.DESIGN: Randomized controlled animalstudy.SETTING: Tumor Center of Zhujiang Hospital affiliated to Southern Medical University, the Third General Surgery of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Animal Laboratory of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA from April 2003 to May 2004. A total of 17 healthy adult hybrid dogs were randomly divided into three groups: treatment group (n=10),non-treatment group (n=5) and normal control group (n=2), according to randomly digital table.METHODS: Ischemic models of left hindlimb were established in treatment group and non-treatment group. Fourteen days later, dogs in treatment group were given negative pressure (-12kPa) treatment for 15 minutes. The negative pressure was done once a day for 10 successive days.However, negative pressure was not done in non-treatment group. Animals were not interfered in normal control group.MAIN OUTCOME MEASURES: Twenty-four days later, dogs in each group were anesthetized and sacrificed. L1-L5 spinal cord and ganglia of dorsal root were selected and stained with immunohistochemical method to detect average giay value of immunologic reaction positive nerve fiber of prostaglandin E 1.RESULTS: A total of 17 dogs were involved in the final analysis. Average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord were 75.23±4.3 in non-treatment group, 43.22±3.7 in treatment group and 22.00±5.8 in normal control group; average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in ganglia of dorsal root were 67.12±2.3, 40.08±3.8, 27.64±2.7, respectively.There was no significant difference among the three groups (P＜0.01).CONCLUSION: After onset of peripheral arterial occlusion, amount of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord and ganglia of dorsal root of distal limbs is increased remarkably, and this may be a kink of auto-protective mechanism of organism. Negative pressure can relieve pain of limbs and decrease damaged-stimulated transmission of peripheral arterial occlusion.

Objective · To explore family medical intervention model of senile dementia with behavioral and psychological symptoms. Methods · Four streets of Changning District in Shanghai were randomly selected and subjects were enrolled according to the inclusion criteria, who were randomly divided into the intervention group (n=71) and control group (n=70). The intervention group received door-to-door service from psychiatric doctors, given drug treatment and psychological intervention. Subjects were evaluated by several scales, including Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Mini-Mental State of Examination (MMSE), Activity of Daily Living Scale (ADL), Quality of Life-Alzheimer's Disease (QOL-AD), and Generic Quality of Life Inventory-74 (GQOLI-74), at baseline and by the end of 6 months and 12 months. Results · ① There was no significant difference in the total scores and all factor scores of BEHAVE-AD between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the total scores of BEHAVE-AD and the factor scores of affective disorder, anxiety and terror (P<0.001). The interactive effect of time×group was significant in the total scores of BEHAVE-AD and the factor scores of delusion and affective disorder (P<0.05). ② Intergroup comparison of the BEHAVE-AD scores indicated that by the end of 6 months, factor scores of hallucination, circadian rhythm disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). By the end of 12 months, total scores of BEHAVE-AD, and factor scores of delusion, conduct disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). ③ There was no significant difference in the scores of MMSE, ADL, QOL-AD and GQOLI-74 between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the scores of MMSE and QOL-AD (P<0.001). The interactive effect of time×group was significant in the scores of MMSE, ADL, QOL-AD, and GQOLI-74 (P<0.05). ④ Inter-group comparison of MMSE, ADL, QOL-AD, and GQOLI-74 scores indicated that by the end of 6 months, scores of MMSE of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). By the end of 12 months, scores of MMSE, ADL, QOL-AD, and GQOLI-74 of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). Conclusion · The family medical intervention model of door-to-door services from psychiatrists integrating multidisciplinary team is effective to attenuate the mental and behavioral symptoms of senile dementia patients, and can improve the quality of life of patients and caregivers. The effect of persistent implementation will be more remarkable.

Objectiye To observe the prevalence of prolonged seizures and the changes of biochemical markers of myocardial injury in patients with prolonged seizures after modified electroconvulsive therapy(MECT).Methods Patients treated with MECT or simulated ECT were divided into three groups.Group Ⅰ , 26 patients,experienced at least one prolonged seizure after MECT;group Ⅱ,41 selected patients, had not prolonged seizures at all during a course of MECT treatments and group Ⅲ, 31 patients, received simulated ECT.Biochemical markers of myocardial injury, including phosphocreatine kinase (CK), MR isoenzyme of phosphocreatine kinase (CK-MB), lactate dehydrogenase ( LDH ), α-hydroxybutyrate dehydrogenase ( α-HBDH ) and cardiac troponin (cTnT) ,were measured immediately, 3 hours later and on the following day after the first prolonged seizure for group Ⅰ ,the same time points as group Ⅰ after the first treatment of MECT for group Ⅱ , immediately after simulated ECT for group Ⅲ.These indexes were compared between the patients of three groups.Results The positive rate ofcTnT was 30.8%(8/26) and 17.1% (7/41)in group Ⅰ and Ⅱ respectively, but no difference was found(P＞0.05 ).CK measured immediately after MECT in patients of group Ⅰ was significantly higher than that of group Ⅲ(P ＜ 0.05 ).CK-MB (immediately), LDH ( immediately and 3 hours later) and α-HBDH ( immediately, 3 hours later and on the following day) in patients of group Ⅰ were significantly higher than those of group Ⅱ and Ⅲ measured after MECT or simulated ECT(P＜0.05 ).Conclusion More attention should be paid that absolute or relative hypoxemia may lead to minor myocardial injury.

Bactericidal/permeability-increasing protein (BPI) can bind to and specifically neutralize lipopolysaccharide (LPS) from the outer membrane of Gram-negative bacteria. In order to evaluate potent LPS-neutralizing activity of bovine BPI, the full-length coding sequence (1 449bp) or 714 bp N-terminal coding sequence (BPI714) of bovine BPI was transfected into mHEK293 cells and the expression of LPS-induced inflammatory cytokines was studied. First, we constructed the lentiviral expression vectors and generated mHEK293 cells stably expressing recombinant bovine BPI or BPI714. Then, we detected the expression of IL-8, IL-1β, TNF-α, NF-κB-1 and NF-κB-2 genes by real-time PCR at 0, 1, 3, 6, 12, 24, 36 and 48 h post of LPS induction in cells with or without recombinant bovine BPI or BPI714 ectopic expression, respectively. In response to LPS, the robust abundance of inflammatory cytokines including IL-8, IL-1β, TNF-α and NF-κB-2 was observed in wild type mHEK293 cells at eachtime point. On the contrary, mRNA abundance of IL-8, TNF-α and NF-κB-2 in transfected mHEK293 cells showed no significant changes at each indicated time point. Our results demonstrated that recombinant bovine full length BPI or BPI714 down-regulated the expression of inflammatory cytokines and revealed that either of bovine BPI or BPI714 was able to inhibit the immune respond stimulated by LPS. This study provides evidence for further investigating the mechanisms and application of BPI/LPS-neutralizing activity and also documents a reliable approach for analysis of the efficacy of antibacterial proteins.
Animals ; Antimicrobial Cationic Peptides ; chemistry ; Blood Proteins ; chemistry ; Cattle ; Cytokines ; biosynthesis ; HEK293 Cells ; Humans ; Interleukins ; biosynthesis ; Lipopolysaccharides ; chemistry ; NF-kappa B ; biosynthesis ; Transfection ; Tumor Necrosis Factor-alpha ; biosynthesis

We retrospectively analyzed clinical and imaging data of 26 children with split cord malformations (SCMs). Based on Pang's classification, 14 SCMs were defined as type Ⅰ and 12 as type Ⅱ.Neural function was markedly improved in 20 patients postoperatively. Three of 4 children who did not undergo surgical treatment had neural function deteriorated. Two children lost follow-up. We suggest that Pang's Classification of SCMs may be useful in describing pathological changes and guiding surgical procedure; imaging examine (including MRI, CT and X-ray) would play a significant role in confirmed SCMs diagnosis; and surgical operation should focus on eliminate and prevent spinal cord damnification.

BACKGROUND: Bone marrow stromal cells(BMSCs) are the ideal gene target cells and will have a bright future in the gene therapy of spinal cord injury.OBJECTIVE :To detect the expression of glial cell line - derived neurotrophic factor(GDNF) gene after BMSCs were infected by adenovirus-medialed GDNF (Adv-GDNF) in vitro and to explore its biological activity.DESIGN: A randomized controlled trial study.SETTING: Laboratory of Orthopedic DepartmentMATERIALS: The experiment was completed in the Laboratory of Orthopedic Department, Affiliated Tongji Hospital of Tong ji Meidcal College,Huazhong University of Science and Technology. Twenty-four SD rats of either gender, weighing (180 ± 20) g.INTERVENTIONS: BMSCs were infected by Adv-GDNF in vitro and then cocultured with spinal cord dorsal root ganglion. The three methods, immunofluorescent chemistry, reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay(ELISA) were used to evaluate GDNF expression in the BMSCs. The biological activity of GDNF was observed by a phase contrast microscope.MAIN OUTCOME MEASURES:Primary outcomes:①RT-PCR;②results of immunofluorescent chemical examination;③biological activity of GDNF in vitro. Secondary outcomes:①culturing and identification of BMSCs②time-effect relationship of GDNF expression revealed by ELISA.RESULTS: Immunofluorescence displayed expression of GDNF in BMSCs 48hours after Adv-GNDF infection. RT-PCR analysis demonstrated expression of GDNF mRNA 24 hours after Adv-GNDF infection. ELISA confirmed the presence of GDNF in the liquid supernatant of BMSCs 24 hours after Adv-GDNF infectionn and showed that GDNF was secreted. The supernatant can promote the neurite outgrowth in the rat dorsal root ganglion(DRG).CONCLUSION: It is demonstrated that BMSCs infected by Adv-GDNF can express GDNF steadily and the expressed GDNF has the activity of promoting neurite outgrowth, which lays a foundation of the GDNF gene therapy for spinal cord injury.

Objective To assess the feasibility of adenoviral vectors mediate cochlear gene transfer by postau-ricular microinjection through the round window membrane in mouse. Methods Twelve 5-week old C57BL/6J mice were selected for the study: 8 were implanted with Ad-EGFP by postauricular microinjection through the round window membrane, and 4 with artificial perilymphatic fluid. On postoperative days 5 and 14, the animals were sac-rificed and the surface preparation of cochleae was observed. Results Two animals died after operation. Bright green fluorescence in the cochleae was observed in Ad- EGFP groups. Gene expression on day 14 after operation was higher than that on day 5. However, the control group was free of fluorescence. Oonclusion The postauricular route of the cochlear gene transfer in mice is simple to operate with little side-effect. The technique of transgenic delivery into the inner ear through RWM by mieroinjection is feasible and effective.

Objective:To compare the clinical outcomes of percutaneous screw fixation at the key points using a self-made calcaneal distraction device with traditional open reduction plate internal fixation for the treatment of patients with displaced intra-articular calcaneal fractures (DIACFs).Methods:A retrospective case-control study was made on clinical data of 60 patients (69 feet) with DIACFs admitted to First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2019. There were 51 males and 9 females, with an average age of 47.2 years [(47.2±8.7)years]. According to the Sanders classification, there were 42 feet of type II, 15 feet of type III and 12 feet of type IV. According to the Essex-Lopresti classification, there were 43 feet of tongue type fractures and 23 feet of joint depression fractures. Another 3 feet were not applicable to this classification system. In Group A, 30 patients (35 feet) were treated by percutaneous reduction or reduction using tarsal sinus approach with the self-made calcaneal distraction device followed by percutaneous screw fixation. In Group B, 30 patients (34 feet) were treated by open reduction and internal fixation with plates using the traditional extended lateral approach. Waiting time for surgery, operation time, length of hospital stay, efficacy of reduction and fracture healing, American Orthopedic Foot and Ankle Society (AOFAS) score, Maryland score, visual analog scale (VAS), and incidence of surgical site related complications were compared between groups. The efficacy of reduction was evaluated by measuring the height, length and width as well as the B?hler angle of the calcaneus.Results:All patients were followed up for an average of 28.2 months [(28.2±11.3)months]. The waiting time for surgery in Group A was (3.4±1.3)days, significantly shorter than that in Group B [(6.9±1.9)days] ( P<0.05). The operation time was (91.7±10.3)minutes in Group A and (92.8±11.5)minutes in Group B ( P>0.05). The length of hospital stay in Group A was (7.0±1.4)days, significantly shorter than that in Group B [(12.7±1.7)days] ( P<0.05). At the final follow-up, all fractures were healed, with no reduction loss of fixation observed. The height of the calcaneus was (48.9±2.0)mm in Group A and (49.3±2.6)mm in Group B ( P>0.05). The length of the calcaneus was (83.2±2.9)mm in Group A and (83.5±2.7)mm in Group B ( P>0.05). The width of the calcaneus was (35.8±2.3)mm in Group A and (35.1±1.3)mm in Group B ( P>0.05). The B?hler angle of the calcaneus was (24.7±6.4)° in Group A and (25.9±5.8)° in Group B ( P>0.05). At the final follow-up, the AOFAS score was (87.1±8.5)points in Group A and (86.7±7.8)points in Group B, with the good and excellent rate of 89% (31/35) and 88% (30/34) respectively ( P>0.05). The Maryland score was (85.3±9.5)points in Group A and (84.9±9.5)points in Group B, with the good and excellent rate of 86% (30/35) and 85% (29/34), respectively ( P>0.05). The VAS was (2.3±1.5)points in Group A and (2.5±1.5)points in Group B ( P>0.05). No surgical site related complication was observed in Group A. While in Group B, there was one foot of superficial incision infection, three necrosis of the skin at the edge of the incision, and one deep infection ( P<0.05). Conclusions:For the treatment of DIACFs, percutaneous screw fixation at the key point using the self-made calcaneal distraction device can achieve the same clinical outcome as traditional open reduction plate internal fixation, but it has advantages like significant shorter waiting time for surgery, less invasiveness, faster recovery and lower incidence of incision-related complications. This method is especially suitable for patients with contraindications of open reduction and internal fixation.