Objective The investitgation of vascularized periosteal flap with dorsal branch of anterior interossea vessel was performed to provide anatomical basis for periosteal flap transposition. Methods The courses, branches, distribution and anastomosis of the dorsal branch of anterior interossea vessel were observed on 30 sides of adult cadavers' upper extremities and stimulated operation were perfomed. Results The dorsal branch penetrate out of interosseous membrane of forearm at (6. 6? 1. 4) cm upper the styloid process of the radius. It also sent off branches to the dorsal of ulna and radius that consist the periosteal flap. The dorsal branch send off lateral and medial branch about (2. 6?0. 8) cm upper the styloid process of the radius. The end of the branch anastomoses with dorsal carpal branch of the ulnar and radial vessel' Conclusion The pedicled osteoperiosteal flap can be transferred for repairing the fracture nonunion of ulna and radius and transpose reversely to repair scaphoid and innate bone disease'

Objective To analyze the clinical conditions and emergency treatment experiences of acute and chronic renal failure with hyperpotassemia. Methods Retrospective analyzed 542 clinical cases of supervening hyperpotassemia, which were treated by hemodialysis on 186 patients of renal failure with hyperpotassemia for 5 years. Results 540 cases clinical symptom was improved, serum potassium concentration was down to normal range and hyperpotassemia disappeared in electro cardiogram. 2 cases died after salvage. Rate of success was 99.6%. Conclusion Hemodialysis therapy is the most effective treatment to hyperpotassemia. Use bicarbonate with kalium pH indicator of 3.0～3.5mmol/L in dialysis is useful to lower hyperpotassemia, and safe also. In the early stage of hemodialysis, pure ultrafiltration dehydration treatment is not suitable. There is still danger of heartbeat stop deal to high kalium in the early stage of dialysis; emergency treatments should be standby all the time.

Objective To probe the changes of nitric oxide (NO) content and caspase-3 mRNA expression in hippocampus and the correlation between NO and caspase-3 mRNA expression post-status epilepticus (SE). Methods The models of SE were induced by pilocarpine. The nitric oxide content was detected by chromatometry and caspase-3 mRNA expression was observed by reverse transcription polymerase chain reaction (RT-PCR) method. Results The level of NO increased rapidly at 6~72 h post-SE,and was still significantly higher than that of the controls (all (P)0.05).Conclusions The peak expression of nitric oxide is earlier than caspase-3 mRNA post-SE, although they have the similar diversity tendency. Nitric oxide pathway is definitely involved in the seizure initiation and correlated with caspase-3 activation.

Objective To observe the effects of Melatonin on hippocampal neuron apoptosis and caspase-3 expression in epileptic rats. Methods Using model of status epilepticus (SE) induced by Pilocarpine, the rats were administered with melatonin (melatonin group) or saline (Pilocarpine group) before Pilocarpine injection. The apoptotic neuron was detected by TdT-mediated dUTP Nick End Labeling (TUNEL) and caspase-3 expression was observed by immunocytochemistry method, respectively.Results In Pilocarpine group, the number of TUNEL positive neurons began to increase at 6 h post-SE, peaked at 72 h post-SE, and decreased at 7 d post-SE. Caspase-3 immunoreactivity began to increase at 6 h post-SE, peaked at 48 h post-SE, especially in CA1 and CA3 region of hippocampus, began to decrease at 72 h post-SE and dropped to normal level at 7 d post-SE. The numbers of TUNEL positive neurons and caspase-3 expression in Melatonin group were significantly decreased compared to Pilocarpine group at different time points (all P

Objective To identify the role of resistin in insulin resistance(IR) by endoplasmic reticulum(ER) stress in human umbilical vein endothelial cells ( HUVECs) and in rats.Methods HUVECs were cultured in vitro and disposed by resistin (R) or tauro ursodesoxycholic acid (tudca).Expressions of GRP78, P-akt and P-eNOS were determined using Western blotting.Thoracic aortic rings were made and their dilation function exposed to different concentrations of insulin was detected.Changes of vascular morphology were observed by HE staining.Results Results of Western blotting showed that expression of GRP78 was remarkably increased,but P-akt and P-eNOS were markedly decreased in R group.However, there was no difference in expressions of GRP78, P-akt and P-eNOS between tudca group and control group.The insulin induced vasodilation was decreased in R group and there was no difference between tudca group and control.Using HE staining, the R group showed significant medial thickening and proliferation of smooth muscle.Conclusion Resistin can induce insulin resistance in vascular endothelium cells by ER stress.

Objective To study the feasibility and safety for using anesthesia gastroscopy in aged-patients over 80 years old.Methods Selecting 84 cases of aged-patients over 80 years old as anesthesia group(group 1),22 cases of aged-patients over 80 years old as normal gastroscopy group(group 2)and 100 cases of young-middle age as anesthesia control group(group 3).Low dose propofol and fentanyl combined atropine were injected into venous in anesthesia gastroscopy.The BP,HR,SpO2,patients reactions during gastroscopy,stomach peristalsis rates,awake time were detected before,during and after gastroscopy.Results Patients in group 1 felt much less discomfortable than those in group 2.Anesthesia group felt much satisfactorily than normal gastroscopy group.The BP,HR,SpO2 in group 1 were decreased transitorily during examination and resumed rapidly after examination.There were no severe complications in anesthesia gastroscopy.However,the BP and HR were increased obviously in normal gastroscopy group.The dosage of propofol in group 1 was much less than that in group 3.Conclusions The use of anesthesia gastroscopy with low dose propofol and fentanyl combined atropine intravenously in aged-patients over 80 years old is safe and comfortable.

We report a case of a 35-year-old right-handed male patient with drug-resistant mesial temporal lobe epilepsy who developed ipsilateral occipital hematoma after right temporal anterior lobectomy and amygdalohippocampectomy. Patient did not report taking any drugs with anticoagulant effect, such as aspirin or valproate. There was no past history of hypertension and the pre-operation tests were normal. Pre-operative brain magnetic resonance imaging revealed no abnormality in the right occipital lobe. Overdraining of cerebrospinal fluid may have triggered this remote cerebellar hemorrhage.

Objective To investigate the role of soluble cytotoxic T-lymphocyte associated antigen-4 (sCTLA-4) in the pathogenesis of myasthenia gravis (MG) in Fujian province.Methods A total of 80 patients with MG and 80 sex-and age-matched healthy controls were enrolled in the study .MG patients were divided into non-glucocorticoid treatment group and glucocorticoid treatment group , and the latter was further divided into immunosuppressive therapy group and thymusectomy group .Concentrations of sCTLA-4 in ser-ums from above mentioned groups were measured by enzyme-linked immunosorbent assay (ELISA).Results The concentrations of sCTLA-4 in both non-glucocorticoid treatment group and glucocorticoid treatment group were significantly higher than those in the healthy control group (6.03 ng/ml±3.58 ng/ml, 3.44 ng/ml± 2.36 ng/ml vs.0.49 ng/ml±0.95 ng/ml) (χ2=100.67, P<0.001), but sCTLA-4 concentrations in glu-cocorticoid treatment group were lower than those in non-glucocorticoid treatment group (Z=-3.37,P=0.001).With the treatment of glucocorticoid, the sCTLA-4 concentrations were reduced (6.03 ng/ml± 3.58 ng/ml vs.4.56 ng/ml±2.08 ng/ml;t=3.10, P=0.005), and the concentrations of sCTLA-4 were also decreased after thymusectomy therapy (3.86 ng/ml±2.53 ng/ml vs.2.59 ng/ml±2.37 ng/ml; Z=-2.21, P=0.04).However, there was no significant difference in the concentrations of sCTLA-4 before and after immunosuppressive drugs treatment (Z=-1.26,P=0.21).Conclusion The concentration of sCTLA-4 was increased in patients with MG , but with the treatment of glucocorticoid or thymusectomy it could be reduced .

OBJECTIVE:To evaluate the effect and safety of conservative treatment for treating cervical spondylotic radiculopathy by cochrane evaluation systems.DATA SOURCE:CBM(from January 1978 to October 2008),CNKI(from January 1978 to October 2008)and VIP(from January 1989 to October 2008)databases were retrieved by computer and partial documents were searched by hands.DATA SELECTION:Randomized controlled trial was adopted in course of acupuncture and moxibustion treatment for cervicel spondylotic radiculopathy and its quailty was assessed.Dafa source was randomized and semi-randomized controlled.Some evaluations such as random method-selection bias,allocation concealment-selection bias,blind method-performance bias and measurement bias,exclusion.lose to follow-up,withdraw-attrition bias were chosen.MAIN OUTCOME MEASURES:①Abdominal acupuncture needles were superior to the conventional method's efficiency.②Electro-acupuncture plus cupping with barbed floc were superior to the conventional method's efficiency.③Abdominal acupuncture were superior to traction's efficiency.④Cervical traction,electro-acupuncture combined with point injection and massage were superior to traction's efficiency.⑤Traction,electro-acupuncture,massage,TDP-guided were superior to traction,physiotherapy,TDP combined with exercise therepy's efficiency.⑥Vinegar iontophoresis and electro-acupuncture were superior to simple electro-acupuncture's efficiency.⑦Long's approach acupuncture was superior to simple acupuncture's efficiency.⑧Adverse reaction.RESULTS:A total of 1416 subjects were selected from 7 randomized controlled trials.All the studies have selection bias,measurement bias,loss of the high probability of bias,the quality and grade of"C"grade.And only one study proved that the efficiency of the experimental group was better than that of the control group.Study 1 showed that there was insufficient evidence suggested that acupuncture treatment of abdominal cervical spondylotic radiculopathy was efficient than conventional acupuncture.Study 2 showed that there was insufficient evidence suggested that electro-acupuncture plus cupping therapy with barbed floc was efficient than conventional acupuncture to cure cervical spondylotic radiculopathy.Study 3 showed that there was insufficient evidence suggested that acupuncture treatment of abdominal cervical spondylotic rediculopathy was efficient than traction.Study 4 showed that the cervical traction,electro-acupuncture combined with acupoint-injection treatment of cervical spondylotic radiculopathy was efficient than traction combined massage therapy.Study 5 showed that there was insufficient evidence suggested that traction,electro-acupuncture,massage,TDP-guided therapy was efficient than traction,physical therapy,TDP combined with exercise therapy.Study 6 showed that there was insufficient evidence suggested thatelectro-acupuncture combined with vinegar iontophoresis treatment of cervical spondylotic radiculopathy was better than the simple electro-acupuncture therapy.Study 7 showed that there was insufficient evidence suggested that the acupuncture therapy using Long's approach was better than simple acupuncture.No adveme reactions appeared to terminate the test in 7 studies.CONCLUSlON:The above seven studies mainly present with low quality,absence of a unified curative method,small samples,difference of follow-up time,iudgment standard and measurement standard.So more samples,multicenter and more regular randomized controlled trial should be performed.

Objective To explore the spread patterns of retropharyngeal lymph node (RLN) metastasis of nasopharyngeal carcinoma. Methods From July 2003 to March 2005, three hundred and three patients with nasopharyngeal carcinoma in initial treatment were enrolled in this study. All patients underwent magnetic resonance imaging (MRI) before treatment, meanwhile measured the minimal and maximal axial diameters, the longitudinal diameter and the central and craniocaudad locations of each positive RLN. Results A total number of 264 positive RLN were found in 177 patients. The minimal and maximal axial diameters and longitudinal diameter of positive RLN were 9.9, 12.9 and 22.4 mm, respectively. Ipsilateral metastatic RLN were noted as follows: two nodes in 21 patients, three nodes in 3 patients and four nodes in 1 patient. According to the longitudinal central location of 263 positive lateral RLN, the numbers of nodes at occipital bone, C1, C1/C2, C2, C2/C3 and C3 were 27, 166, 40, 23, 5 and 2, respectively; the mean minimal axial diameters of nodes were 6.8, 9.9, 12.5, 10.4, 9.3 and 8.0 mm, respectively. Conclusion Multiple metastatic ipsilateral RLN are not common in NPC. The rate of RLN metastasis shows the trend of decreasing from vertebral C1 to C3.The maximal diameters of RLN are in the C1/C2 intervertebral space, and reveal a decreasing frequency along the craniocaudal directions of occipital and vertebral C1.