ObjectiveTo observe the relationship between neuronal function score,brain edema and aquaporin4(AQP4) expression of fluid percussion brain injury in rats.MethodsThe fluid percussion models of brain injury of rats were established by using the improved device.Nervous function score,brain water content,histological changes,AQP4 expression were observed by Shapira and Wahld method,dry-wet measure,light microscopy,immunohistochemistry and western blot at 1 h,6 h,12 h,24 h,3 d and 7 d after operation respectively.ResultsNervous function score in TBI group decreased at 12 h( 11.17 ± 1.32),reached its minimum at 24 h( 10.17± 0.75),and recoved partially at 3rd day( 10.66 ± 1.37 ).The water content obviusly increased in those of TBI group at 12h( (80.27 ±1.47)％ ),reached its peak at 24h( (82.19 ±0.97)％ ),and then began to drop at 3d ( (8 1.74 ± 1.69 ) ％ ),while Western blot showed that AQP4 immunoreactive expression obviusly increased at 12 h (OD:0.65 ±0.05),reached its maximum at 24h( OD:0.72 ±0.08),and decreased at 3d( OD:0.56 ±0.07),and immunohistochemistry showed the same trendency of AQP4 expression as that of Western blot.The linear regression analysis indicated that nervous function score had a negtive correlation with expression of AQP4 in edematous brain and change of brain water content respectively ( r =- 0.615,P ＜ 0.01 ; r =- 0.605,P ＜ 0.05 ).ConclusionNervous function score of fluid percussion brain injury in rats decrease,has negative relationship with brain edema and AQP4 expression,and possible mechanisms is that AQP4 is indirectly involed in nerve function impairment by mediating brain edema.

Objective To investigate the long-term curative effect of the radiotherapy combined uterine arterial interventional chemoembolization for cervical cancer.Methods Records of 632 patients with cervical cancer stage Ⅱ-Ⅳa proved by pathology in Lanzhou Command General Hospital from January 1st,1999 to August 31st.2009 were retrospective analysed.One hundrand and twenty-six cases of them were treated with radical radiothempy combined uterine arterial interventional chemoembolization(arterial chemoembolization+radiotherapy group).506 cases of them were treated with radical radiotherapy only (radiotherapy group);the evaluation of the late radiation injury was done,according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer(RTOG/EORTC)advanced radiation injury criteria.Prognosis and complications were compared between two groups,relative risk factors of radiothempy complications were identified by method of logistic regression.Results (1)Survival:the total survival mtes of 1-year,2-year,5-year and 8-year were 94.4%,82.3%,48.8%,29.1%,respectively.The survival rates of arterial chemoembolization+radiotherapy group were 96.0%.82.1%,37.2%,25.7%,while the survival rates of radiotherapy group were 94.1%,80.8%,51.1%,31.5%,in which there were significant differences between two groups (x2 = 0.009, P= 0.993; x2 =0. 158, P =0.691;X2 =11. 197,P=0. 001;x2 =9. 649,P =0.002). During the follow-up period, the rate of recurrence and metastasis in arterial chemoembolization + radiotherapy group were 77. 0% (97/126), while 73. 3% (371/ 506) in radiotherapy group ( x2 = 0. 705,P = 0. 401). (2) Radiotherapy complications and relative risk factors; the total incidence of tardive bladder injury higher than RTOG/EORTC stage II was 5.5% (35/632), while it was 11. l%(14/126)in arterial chemoembolization + radiotherapy group, 4.2% (21/506) in the radiotherapy group(x2 =9.344,P =0.002). The results of logistic regression showed that the uterine arterial interventional chemoembolization was relative risk factors of the tardive bladder injury ( x2 =6. 440, OR = 2. 869,P=0. 011). Conclusions Compared with the simple radiotherapy, there are a similar short-term survival rate and significant poor 5-year, 8-year survival rate in the patients treated with the uterine arterial interventional chemoembolization combined with radiotherapy, which also may be strong dangerous factor for the occurrence of tardive bladder injury. The results shown that the uterine arterial interventional chemoem bolization do not recommend to be routine adjuvant therapy for the radical radiotherapy of cervical cancer.

The structure, application and the development foregrounds of mobile water producing system are introduced, and the domestic and international development of water producing system is looked back as well as the clinical situation of mobile water producing system. Furthermore, the merits and defects of mobile water producing system are introduced. Mobile water producing system provides an effective guarantee for settling clinical emergency or bed-side blood purification treatment, and it has vast development foreground.

Objective To determine the mortality and associated risk factors in the patients with diabetic foot ulcers. Methods One hundred and sixty-three patients with diabetic foot ulcers hospitalized from January 2001 to December 2006 were followed up until December 2009. Mortality rates were derived from Kaplan-Meier survival curves. The prognostic factors were evaluated with Cox proportional hazard model. Results Follow-up was successful in 139 out of 163 patients, with a mean follow-up period of(3.71 + 1. 80)years. 55 patients(39 males and 16 females)died during the follow-up. The 5-year mortality was 45.8% and mean survival time was 5.38 years(95% CI 4.87-5.89). The median survival time was 6.83 years. Age, smoking, hypertension, coronary artery disease, and diabetic nephropathy were found to be independent prognostic factors for mortality. Conclusions Diabetic foot ulcers increased the mortality of diabetic patients. Age, smoking, hypertension, coronary artery disease, and diabetic nephropathy were predictive risk factors for mortality.

tomography angiography ( CTA) and T12-S1 vertebral computed tomography three-dimensional reconstruction were selected .The operative win-dows of L1 ~L2 OLIF were observed:the vascular window ,bare window ,psoas major window ,ideal operative window and actual operative win-dow.The operative windows ’ percentage accounted for ideal operative window were calculated ,the actual operative window based on an actual operative window of <1 cm,≥1 cm were statistically analyzed ,and the positions of the left renal artery and renal vein in front of operative window of L1 ~L2 OLIF were observed.Results The actual operative window was <1 cm in 2 cases (3.3%) and ≥1 cm in 58 cases (96.7%).In 58 cases,the difference was significant(P=0.008) in gender and men were more than women.The vascular window,bare win-dow and psoas major window accounted for the ideal operative window by 45%,43%and 12%,respectively ,and the actual operative window accounted for the ideal operative window by 55%.The left renal artery and renal vein's walking planes were at between the middle 1/3 of L1 to up 1/3 of L2 .There were 31 cases (51.7%) of the left renal artery being behind the left renal vein .Conclusion The regional anatomy of the operative window of L1 ~L2 OLIF has its own peculiarities,and not all L1 ~L2 levels are suitable for OLIF.The left renal vessels’ walk-ing planes were in front of L 1 ~L2 .Before L1 ~L2 OLIF surgery,surgeons should analyze the imaging anatomimy through imaging .

Objective To investigate the related factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy in the treatment of upper urinary tract stones.Methods The clinical data of 101 patients after percutaneous nephrolithotomy from August 2016 to April 2018 in Miyun Teaching Hospital,Capital Medical University were retrospectively analysed.Screened the independent variable such as gender,with fever or not,with diabetes or not,with hydronephrosis or not,urine leucocyte count,volume of urinary calculi,CT attenuation value of urinary calculi and presence of intraoperative infection,and analyzed the relationship those with systemic inflammatory response syndrome after surgery.Univariate and multivariate logistic regression analysis the factors related to systemic inflammatory response in patients after surgery.Results Of the 101 patients,62 cases was male,and 39 cases was female,12 (11.9％) suffered postoperative systemic inflammatory response syndrome.Univariate regression analysis indicated that the risk factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy were gender,with diabetes or not,urine leucocyte count,volume of urinary calculi and presence of intraoperative infection.Furthermore,multivariate logistic regression analysis revealed that with diabetes,intraoperative infection,urine leucocyte count and volume of urinary calculi were the independent factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy.Conclusion Patients with diabetes,intraoperative infection,urine leucocyte count and volume of urinary calculi could be predicted as the independent factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy,but it has no relationship with gender,with a history of fever or not,with hydronephrosis or not,and CT attenuation value of urinary calculi.

OBJECTIVETo explore the correlation between cytogenetic findings and clinical manifestations of Turner syndrome.

METHODS607 cases of cytogenetically diagnosed Turner syndrome, including those with a major manifestation of Turner syndrome, were analyzed with conventional G-banding. Correlation between the karyotypes and clinical features were analyzed.

RESULTSAmong the 607 cases, there were 154 cases with monosomy X (25.37%). Mosaicism monosomy X was found in 240 patients (39.54%), which included 194 (80.83%) with a low proportion of 45,X (3 ≤ the number of 45, X ≤5, while the normal cells ≥ 30). Structural X chromosome abnormalities were found in 173 patients (28.50%). A supernumerary marker chromosome was found in 40 cases (6.59%). Most patients with typical manifestations of Turner syndrome were under 11 years of age and whose karyotypes were mainly 45,X. The karyotype of patients between 11 and 18 years old was mainly 45,X, 46,X,i(X)(q10) and mos45,X/46,X,i(X)(q10), which all had primary amenorrhea in addition to the typical clinical manifestations. The karyotype of patients over 18 years of age were mainly mosaicism with a low proportion of 45,X, whom all had primary infertility. 53 patients had a history of pregnancy, which included 48 with non-structural abnormalities of X chromosome and 5 with abnormal structure of X chromosome.

CONCLUSIONGenerally, the higher proportion of cells with an abnormal karyotype, the more severe were the clinical symptoms and the earlier clinical recognition. Karyotyping analysis can provide guidance for the early diagnosis of Turner syndrome, especially those with a low proportion of 45,X.

Abortion, Spontaneous ; genetics ; Adolescent ; Adult ; Amenorrhea ; genetics ; Child ; Child, Preschool ; Chromosomes, Human, X ; genetics ; Cytogenetic Analysis ; methods ; Female ; Humans ; Infant ; Infant, Newborn ; Karyotyping ; Middle Aged ; Mosaicism ; Pregnancy ; Sex Chromosome Aberrations ; Turner Syndrome ; genetics ; pathology ; Young Adult

The number of investigator initiated research (IIR) is increasing. But the recognition and management of IIR in China is still in its infancy, and there is a lack of specific and operable guidance for the implementation process. Based on our practical experiences, previous literature reports, and current policy regulations, the authors took prospective IIR as an example to summarize the implementation process of IIR into 14 steps, which are as the following: study initiation, ethical review, study registration, study filing, case report form design, database establishment, standard operating procedure making, investigator training, informed consent, data collection, data entry, data verification, data locking and data archiving.

Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.