Objective To observe the clinical and nerve electrophysiological features of sodium azide poisonin. Method The clinical data of 11 patients with sodium azide poisonin were analyzed retrospectively.Results In this group, the first symptoms was numbness in 4 cases, weakness in 3 cases, walking instability in 2 cases, dizziness and nausea in 2 cases.The major clinical manifestations were numbness in 8 cases, weakness in 6 cases, walking instability in 4 cases, dizziness and nausea in 3 cases, leptophonia in 2 cases, diplopia in 2 cases, limb muscle strength loss in 7 cases, reducing muscle tension in 3 cases, weakened tendon reflex in 3 cases, skin needle drops in 3 cases.Electrophysiological examination showed motor nerve conduction velocity ( MCV) was slower, distal latency ( DML) and amplitude ( AMP) were reduced; the sensory nerve conduction velocity ( SCV) was slower, and AMP was reduced.The latency (Lat) and wave interval of brainstem auditory evoked potential (BAEP) and visual evoked potential ( VEP) , somatosensory evoked potentials ( SEP) were prolonged, and AMP was reduced.Compared with pre-treatment, the abnormal rates of MCV, AMP, DML of median nerve, ulnar nerve, deep peroneal nerve and SCV, AMP of median nerve, ulnar nerve, superficial peroneal nerve, sural nerve and AMP of SEP after treatment had no statistically significant (all P>0.05).Compared with pre-treatment, the abnormal rates of Lat of BAEP, VEP, SEP andⅢ-Ⅴof BAEP and AMP of BAEP, VEP had no statistically significant (P<0.05-0.01).Conclusions The major clinical symptoms of sodium azide poisoning are numbness, weakness, unstable walking, dizziness, diplopia. Electrophysiological examination showed MCV is slower, DML and AMP are reduced; SCV is slower, and AMP is reduced.The Lat and wave interval of evoked potential are prolonged, and AMP is reduced.

A method of solid phase extraction coupled with ultra performance liquid chromatography-tandem mass spectrometry ( SPE-UPLC/MS/MS) was developed for the determination of 15 phthalate esters. Drinking water samples were concentrated by C18 SPE cartridge. The fifteen phthalate esters were separated on a phenyl column with gradient elution using methanol and water as mobile phases. Multiple reaction monitoring ( MRM) acquisition under positive ion mode was performed. The external matrix standard solutions were used for the quantitative determination. The linear range of Di-n-butyl phthalate was 0. 63-1000 μg/L. The other 14 phthalate esters showed good linearity in the range of 0 . 002-500 μg/L with the correlation coefficients more than 0. 9970. The limits of quantification ( LOQ) were 2. 2-632 ng/L. The spiked recoveries ranged from 81 . 3% to 109%. The relative standard deviations were less than 14%.

BACKGROUND:Ligamentum flavum hypertrophy is one of the most important factors of lumbar spinal stenosis, but the molecular mechanism is stil not very clear. OBJECTIVE:To explore the role of basic fibroblast growth factor, connective tissue growth factor and transforming growth factor β1 in hypertrophy of the lumbar ligamentum flavum. METHODS: The ligamentum flavum samples were divided into three groups according to different diseases: control group (acquired from the patients with lumbar spinal canal tumor,n=6), lumbar disc herniation (LDH) group (acquired from the patients with LDH,n=6) and lumbar spinal stenosis (LSS) group (acquired from the patients with LSS,n=6). Then the mRNA expressions of basic fibroblast growth factor, connective tissue growth factor, transforming growth factor β1 and colagen I, III, V of the ligamentum flavum were detected using real-time quantitative RT-PCR method. The roles of basic fibroblast growth factor, connective tissue growth factor and transforming growth factor β1 were explored. RESULTS AND CONCLUSION:The expression of basic fibroblast growth factor mRNA in the LSS group was significantly higher than that in the LDH and control groups (bothP < 0.05); the expression of connective tissue growth factor mRNA was not found statisticaly different among the three groups, although it was slightly higher in the LSS group (P> 0.05); the expression of transforming growth factor β1 mRNA was significantly higher in the LSS group than in the LDH and control groups (bothP < 0.01). The colagen I mRNA expressed significantly higher in the LSS group than the LDH and control groups (bothP < 0.05), but both the colagen III and V mRNA showed no significant difference among the three groups (P> 0.05). This study indicate that both basic fibroblast growth factor and transforming growth factor β1 play important roles in the formation process of the lumbar ligamentum flavum hypertrophy, and the main type of the colagen in the hypertrophied ligamentum flavum is colagen I.

To discover medical teaching method which is more funny and effective in early clinical contact education, Eye optical hospital affiliated to Wenzhou Medical University set up oph-thalmic microsurgery experience teaching course for junior medical students and set a variety of eye surgery simulation experience content, such as conjunctival suture surgery, corneal suture surgery, cataract surgery, eye surgery simulation and so on, which can effectively arouse students' professional interest in learning and promote students' thinking and exploration to their profession.

Objective To evaluate the effect of combination of surgery and transcatheter hepatic arterial chemotherapic embolism(THACE) with or without placement of drug deliery system(DDS) of portal vein for hepatocellular carcinoma with portal vein tumor thrombus (PVTT). Methods Fifteen cases of advanced HCC with PVTT were treated by hepatectomy, thrombectomy of portal vein with THACE,and 5 of the 15 cases received postoperative chemotherapy via portal vein. Results All patients survived after operation. The survival rate of 6,12,18 months was 15,12 and 9 cases respectively. Conclusions Operation is still an effective method for advanced HCC , postoperative comprehensive treatment can improve the survival rate.

Objective To compare the effect and safety of arthroscopic debridement enmbined with intercondylar fossa angioplasty in the elder with knee osteoarthritis.Methods Six-eight elderly with knee osteoarthritis were selected from June 2012 to December 2014 in this hospital and they were averagely and randomly divided into group A and B.Patients in group A were given arthroscopic debridement,while in group B were given and arthroscopic debridement,intercondylar fossa angioplasty.The levels of VAS scores,Lysholm scores,WOMAC scores and joint range of motion were measured and compared between the two groups after 3 months,6 months and 12 months of operation.The adverse events of the two groups were supervised and compared as well.Results All elder in the two groups had apparently decreasing in VAS scores and WOMAC scores (P＜0.05) after operation.Compared with group A,patients in group B had lower levels of VAS scores and WOMAC scores(P＜0.05) at 12 months after operation.The level of Lysholm score was significantly increased in the two groups after treatment(P＜0.05),while group B had a higher level at 12 months after treatment than group A (P＜0.05).The joint range of motion in the two groups were improved after treatment(P＜0.05).The elder patients in group B had better joint range of motion than group A at 6 and 12 months after operation (P＜0.05).Early postoperative swelling in the joints was the adverse event after operation,but there was no statistically difference between two groups.Conclusion The combination of arthroscopic debridement and intercondylar fossa angioplasty is effective to release knee pain,increase the clinical efficacy and improve the knee function.

AIM: To investigate the role of phosphoinositide pathway in the formation of pressure-overload cardiac hypertrophy. METHODS: Cardiac hypertrophy was induced in male Sprague-Dawley rats with coarctation of abdominal aorta, whole heart weight/body weight ratio was tested after 10 or 30 days of operation. Content of G?q/11 protein in left ventricle was detected by immunoblot analysis and concentration of IP 3 was measured by radioimmunoassay. RESULTS: At 10 and 30 days, whole heart weight/body weight ratio of coarctation aorta (CA) group was higher than that of sham-operated (SO) rats ( P 0.05). At 10 days, the level of IP 3 significantly increased in left ventricle of CA rats compared with the control animals ( P

The free membrane of Eudragit L100/S100 which is pH-sensitive, colon-specific was prepared by plane casting films. The film humidity, species and amount of plasticizers, the ratio of membrane material was investigated. The rate of membrane permeability and mechanical properties were used as indicators of orthogonal experiment, and its related properties were studied. The results show that the mechanical properties of the membrane and phragmoid capacity are the best when 30% TEC was used as plasticizer; the ratio of membrane material have little effect on the rate of membrane permeability and mechanical properties. By adjusting the species and amount of plasticizers, the ratio of Eudragit L100/S100, the free membrane which is colon-specific can be obtained.

The first case of acquired syphilitic skull osteitis accompanied by syphilitic meningitis in China is reported.A 55-year-old female presented with a persistent distending pain of the frontal and occipital regions of the skull for two months.T1 weighted magnetic resonance imaging(MR1) showed muhiple lesions in the skull and linear enhancement of the meninge near the lesions.The serum and cerebrospinal fluid (CSF) were positive for Treponema pallidum particle agglutination assay (TPPA) and rapid plasma reagin circle card test(at the dilutions of 1∶32 and 1∶4 respectively).The levels of leukocyte and protein were 10 ×106/L and 0.82 g/L respectively in CSF.TP DNA was detected in the calvarial periosteum.Histopathological examination of the frontal bone showed focally destructive osteolytic lesions with obscure texture of the bone,hyperemia around the destructive bone tissue and in dura mater-like tissues,proliferation of interstitial fibrous tissue,swelling of endothelial cells and inflammatory infiltration predominantly composed of abundant plasma cells.After managed with routine treatment regimen for neurosyphilis,her headache was relieved 3 days later,nearly disappeared 15 days later,completely disappeared 30 days later.No similar headache recurred.A 5year follow up demonstrated a satisfactory long-term and short-term outcome.She was finally diagnosed with syphilitic skull osteitis complicated by syphilitic meningitis.

Objective To investigate the comprehensive treatment of Crohn's disease complicated with anal fistula.Methods The clinical data of 33 patients with Crohn's disease complicated with anal fistula who were admitted to the Sixth Hospital of Sun Yat-Sen University from June 2007 to April 2011 were retrospectively analyzed.According to the range of the disease,surgical,medical and combined treatment were applied.Surgical treatment included thread-drawing drainage,fistulectomy,incision and drainage of the perianal abscess and enterostomy.Medical treatment include 5-aminosalicylic acid,immunosuppressive therapy,glucocorticoid,tumor necrosis factor monoclonal antibodies.All the patients were followed up till August 2012.The Crohn's disease activity index (CDAI) and perianal Crohn's disease activity index (PDAI) before and after treatment were analyzed using the independent sample t test.Results Of the 33 patients,22 received surgical and medical treatment,7 received surgical treatment,and 4 received medical treatment.The anal fistula was healed in 18 patients after the initial treatment (3 of them did not receive surgical treatment),and the mean closure time of the fistula was (3.2 ± 2.6) months (range,1-12 months) ; the condition of 8 patients was improved ; 4 patients suffered from fistula persistence ; anal fistula recurrence was observed in 6 patients,and the time for anal fistula recurrence was (35 ±56)months (range,5-148 months).The preoperative CDAI and PDAI of the 33 patients were 166 ± 100 (range,7-361) and 9.2 ± 2.6 (range,5-16),and the postoperative CDAI and PDAI of the 33 patients were 83 ± 53 (range,0-212) and 2.7 ± 3.1 (range,0-11).There were significant differences between the pre-and postoperative CDAI and PDAI (t =4.20,8.92,P ＜0.05).Of the 12 patients who were failed in the initial treatment,the anal fistula was healed in 3 patients after the treatment,and the condition of the other 9 patients remained the same.Of the 6 patients with anal fistula recurrence,5 received reoperation (4 were healed and 1 remained the same after the treatment) and the fistula of 1 patient who received medical treatment was not healed.At the end of the follow up,the anal fistulas of 20 patients were healed,and 10 remained the same.Conclusions There is no standard treatment for Crohn's disease complicated with anal fistula,surgical treatment combined with medical treatment is important for the treatment of Crohn's disease complicated with anal fistula.Surgical procedures should be chosen carefully according to the condition of the patients.