OBJECTIVE:To explore short-term efficacy and safety of early use of high-dose,medium-dose and low-dose ami-no acid in premature babies. METHODS:99 premature babies were selected and randomly divided into high-dose group,medi-um-dose group and low-dose group,with 33 cases in each group. 3 groups were given Amino acid injection,ivgtt,within 24 h af-ter birth,high-dose group was given 3 g/(kg·d),medium-dose group 2 g/(kg·d)and low-dose group 1 g/(kg·d);those dose in-creased by 0.5 g/(kg·d)day by day;predicted peak values of them were 3.5,3.5 and 3 g/(kg·d),respectively. Treatment courses of 3 groups lasted for 28 d. Health indexes,renal function indexes and blood indexes were observed in 3 groups. The occurrence of complications and ADR were recorded in 3 groups. RESULTS:2 cases withdrew from high-dose and low-dose groups. Hospital-ization stay,the time of body weight increasing to 2 500 g and the rate of body weight decreasing in high-dose group were signifi-cantly lower or shorter than in medium-dose and low-dose groups;the medium-dose group was significantly lower or shorter than the low-dose group,with statistical significance (P<0.05);the levels of creatinine,residual alkali,serum total bilirubin in high-dose group were significantly higher than medium-dose and low-dose groups,and the medium-dose group was significantly higher than the low-dose group,with statistical significance(P<0.05). The number of complications cases in high-dose group(11 cases)were significantly lower than in medium-dose group(20 cases)and low-dose group(26 cases),with statistical significance (P<0.05). No obvious ADR was found in 3 groups. CONCLUSIONS:High-dose of amino acid intravenous nutrition support in early stage can promote the recovery of nutrition state and healthy constitution in premature babies with good tolerance and safety.

The authors adopted an auto control experimental research on 18 male adult dogs with 36 sides of femoral heads and necks which were divided into two groups. They were separately made models of old fracture of femoral neck and avascular necrosis of famoral head. Two wecks later, The free fibula with microvascular an astomosis was tranplanted. All experimental dogs were examined with X-ray, pathohitology, electron microscopy, 99~mTc-MDP scanning and tetracycling labeling after operation.The experiment showed that the free fibular graft with mierovascular anastomosis could provided a new system of vascula supply to the injured femoral head. The hard free fibula and the metallic internal fixation were inserted in femoral head and neck. After the Operation, in the fracture area the fibula formed a bone-bridge which not only diminished the stress force but also prevented rotation displacement of the bone fracture The periosteum of the transplanted fibula also took part in the repair course of avascular nerosis of femoral head.

Objective To study the effect of recombinant human erythropoietin (rHuEPO) on in aged patients undergoing maintenance hemodialysis. Methods Blood pressure and its mechanism 52 elderly patients undergoing maintenance hemodialysis divided into two groups, HBP group (23 cases with hypertension) and NBP group(29 cases without hypertension). The plasma vasoactive substances were measured by radioimmunological methods. Fifteen cases in NBP group as EPO group were given a bolus of venous injection of rHuEPO (3 000 IU), others in NBP group (14 cases) were injected 0.9% saline as control group. The plasma vasoactive substances were assayed before and 1, 3, 6, 9, 12, 18, 24, 30, 44 hours after therapy with or without rHuEPO. Results (1) The plasma dopamine (DA) in HBP group were significantly higher than that of NBP group. (2) Endothelin levels increased transiently but DA levels increased steadily in EPO group. Conclusions The study suggests that the effect of rHuEPO induced on hypertension in the elderly patients undergoing maintenance hemodialysis is associated with the increasing plasma DA.

Objective To explore the indications of physiotherapy and operative treatment for gluteal muscles contracture, and discuss the principles and necessity of classification in order to facilitate clinical management. Methods The standards of classification of gluteal muscles contracture were based on the signs and pathological examination, It consisted of three stages upon our standards. 210 patients could be divided into stage Ⅰof 23 cases, stage Ⅱand Ⅲ of 187 cases. For the patients of stageⅠ, physiotherapy was performed; However, all cases of stageⅡand Ⅲ, operative treatment was adopted by small superomedial incision above the greater trochanter. Furthermore, in the cases of stage Ⅱ, tight fibrotic gluteal muscles and thick contracted fascia lata should be released; For stage Ⅲ lesion, the release should be extended to the capsule of hip, and incision of the posterior capsule was necessary. Results In the group of stageⅠ, The symptoms and signs were relieved by maneuver , the rate of excellent and good results was 39%; while in the group of stageⅡand Ⅲ, it was 97% by operative treatment. Conclusion The staging system of gluteal muscles contracture could demonstrate exactly the severity degree of the disease, and is useful in choosing therapeutic method. Non-operatiive method can obtain satisfactory results in about 1/3 cases of stage Ⅰof gluteal muscles contracture; operative method is indicated for the patients of stage Ⅱand Ⅲ.

Objective To discuss the therapeutic effect of fracture operation on multiple bone injuries. Methods The patients with fractures were treated with 3 different methods, ie, emergency, selective and conservative treatments. Early complications such as acute respiratory distress syndrome (ARDS),fat embolism syndrome (FES),duration in insive care unit and mortality rate were compared with the long-term complications of fractures so as to evaluate the curative effect of 3 different methods on multiple bone injuries. Results Among 91 cases (ISS≥30), one died and 2 resulted in FES. Mortality rate, short-term and long-term complications and mean ICU duration were reduced significantly in the emergency treatmentgroup compared with the other two groups ( P

[Objective]To explore the clinical character and the treatment method of wedge-shaped vertebral osteotomy,expanding bone graft and spanning segment pedicle screw-rod system fixation from posterior approach to the thoracolumbar kyphosis caused by old fracture.[Method]From June 2003 to May 2008,26 cases of kyphosis deformity at thoracolumbar segment were treated with wedge-shaped vertebral osteoctomy and long segment pedicle screw-rod internal fixation,including 19 males and 7 females and aging 16-45 years(average age:24.2 years).All kyphosis deformity were caused by old thoracolumbar fracture and patients suffered from back pain.The average disease history were 12.6 years.All the sigittal kyphosis Cobb's angles were more than 40 degree cases.Sixteen patients complicated with nervous symptom.Among them 18 cases were given wedge-shaped vertebral osteoctomy and long segment pedicle screw internal fixation,8 cases were given expanding bone graft in anterior of vertebra after osteotomy.The kyphosis angles from radiographs were given compared between pre-and postoperatively,and complications were given analysis too.[Result]Twenty-two patients had been followed up for 12-48 months(average time:34.6 months),all patients' kyphosis angles were corrected satisfactory,the extend of right angle were 86.45%?4.56%.Besides mesenteric artery compressed syndrome happened in 1 patient,other complication was rare.[Conclusion]This method can correct the kyphosis deformity immediately in operation,its correct extent is large,expanding bone graft in anterior of vertebra after osteotomy can reduce the spine shorten and spinal cord injury rate.

Objective To investigate effective dosage of ACEI in renoprotective effect in primary glomerular dieases.Method In 154 patients with primary glomerular diseases,we performed a 4 month therapy,including 40 cases with high or low doses of captopril and 51 cases with high or low doses of cilazapril and 45 cases with high low doses of enalapril,and 18 cases with amlodipine as control.Mean arterial pressure (MAP),uninary protein,urinary albumin excretion rate and renal function were measured at basis and after 1,2,3,4 month of therapy,and ACE gene polymorphism was determined in these patients.Result 1.There were no difference on ACE gene polymorphism and diet protein and diet salt among control group and different ACEIs group;2.The antiproteinuria and the effect on renal function were same between patients with high and low dose of different ACEIs.Conclusion The low dose of ACEI has the same renoprotective effect as general dose in primary glomerular diseases.

Objective To screen out useful monitors of heparin therapy in glomerular diseases.Methods In 40 diabetic nephropathy (DN) patients and 39 chronic glomerulonephritis (CGN) patients,we implemented a bolus venous injection of heparin 1500 U,and measured the parameters of coagulation and fibrinolysis by ELISA at basis and 30 minutes,2 hours after injection.Result After injection with heparin,the levels of prothrombin fragment 1+2 (PF1+2),thrombi-antithrombin Ⅲ (TAT),fibrinopeptide A (FPA) and coagulative factor X (FX) activity significantly decreased,but the activated partial thromboplastin time (APTT) and the other parameters of coagulation-fibrinolysis didn't change in either the DN patients or the CGN patients.Conclusion The level of PF1+2,TAT,FPA and XF activity are valuable monitors in heparin therapy.

Objective To study the mRNA and protein expressions of the neurofilament in the region of acute spinal cord injury (SCI) of rats after olfactory ensheating cells (OECs) transplantation combined with methyprednisolone administration and investigate the molecular mechanisms of OECs transplantation combined with methyprednisolone administration in promoting the recovery of the spinal cord.Methods Acute spinal cord injury was established in SD rats ( T10 ) by using NYU instrument. The rats were randomly divided into control group, SCI group, DF12 group, OECs transplantation group,methyprednisolone administration group and OECs + methyprcdnisolone group. The mRNA and protein expressions of the neurofilament in the SCI regions of rats in different groups at different time points were detected by using immunohistochemistry, RT-PCR and Western blotting. Results A significant increase of mRNA and protein expressions of the neurofilament could be found in the other five groups compared with the control group at days 7, 14 and 28 after SCI. The mRNA and protein expressions of the neurofilament in the injury region of the OECs group, the methyprednisolone group and the OECs + MP group were more significantly increased than that of the SCI group and the DF12 group. The expression of the neurofilament in the injury region of the OECs + MP group was more significantly increased than that of the OECs group and the MP group ( P ＜ 0. 05). Conclusions OECs transplantation or methyprednisolone administration can induce the mRNA and protein expressions of the neurofilament. Meanwhile, OECs transplantation combined with methyprednisolone administration can significantly increase the mRNA and protein expressions of the neurofilament, as may be one of mechanisms promoting spinal cord repair.

Homeobox gene Six1,as a transcription factor has been proved to participate in most malignant tumors.Its overexpression is associated with the genesis and development of breast cancer intimately.Overexpression of Six1 in mammary cells is sufficient to induce activation of stem cells.Similarly,Six1-overexpressed tumors could activate the TGF-β pathway and Wnt/β-catenin pathway,lead to malignant transformation by inducing epithelial-mesenchymal transition and mammary tumorigenesis.Research on the role of sixl will improve understanding the mechanisms of breast cancer initiation and development.