Objective To research early diagnosis and treatment of acute spontaneous spinal epidural hematoma (SSEH). Methods Medical records of 13 SSEH patients adimtted in Timone Ste Marguerite Hospital,France and Ruijin Hospital,China from 1985 to 2000 were retrospectively reviewed.The etiology, neurological symptoms, neuroradiology therapy, as well as the prognosis of this rare disease are discussed in comparison with the literaturs.Results Six of thirteen SSEH wee relatd with innormal coagulation. All patients had the same original symptom which was radicular pain. Eleven cases were diagnosed by MRI. After decompressive surgery, recovery occurred in 3 of 5 patients. Five of 8 patients had a favorable outcome after medical treatment. Conclusions The majority of spontaneous hematomas results from a rupture of the venous plexus. It could be diagnosed according typical symptoms and MRI. Decompressive surgery is urgent but not unique. A idiosyncratic type which has a spontaneous complete recovery could be found.

Objective The determination of skeletal maturity is an important measure for selecting sports talent. The characteristics of skeletal development of hand and wrist in Chinese children were investigated in order to compare with overseas experiences. Methods The subjects were 16035 children, aged 2～18 years. The skeletal maturity of hand and wrist of the subjects was estimated by TW3 method and was compared with that of European, European North American and Japanese children. Results In comparison with European and American children, Chinese and Japanese children showed a similar patterns of skeletal maturation. The TW3-RUS skeletal maturity of Chinese children was retarded by 0.3～0.6 year in boys at the age of 8～12 and was very close to European and American in girls at the age of 5～10. Older than 12 years of age in boys and 10 years of age in girls, the TW3-RUS skeletal maturity of Chinese children accelerated and became advanced by 1.1～1.6 years in boys, by 1.2 years in girls. As compared with European and American children, the TW3-carpal maturity delayed by 0.3～0.6 year in Chinese boys at the age of 3～10 and by 0.2～0.4 year in Chinese girls at the age of 2～5. The TW3-carpal maturation accelerated after age of 10 in boys and age of 5 in girls. The age of complete maturity in all carpals was advanced by 1.4 year in boys and girls. Conclusion As compared with European and American children in 1970s-1990s, the delay of skeletal development of hand and wrist in Chinese children was not obvious in childhood, and the extent of advanced skeletal maturity and the age of advanced complete maturity of Chinese children are more evidently.

BACKGROUND: It has been reported that chitosan can inhibit scar formation and promote wound healing. Medical invisible antimicrobial film is a new type of membrane materials which comprises chitosan as ground substance.OBJECTIVE: To determine the inhibitory effects of medical invisible antimicrobial film on the operative incision scar, and to observe its effects on wound healing.DESIGN, TIME AND SETTING: A controlled animal study was conducted at the IVC Experimental Animal Room, West China School of Pharmacy, Sichuan University from August to October 2007.MATERIALS: Medical invisible antimicrobial film stock solution was colorless transparent sticking solution, which formed colorless transparent film following spray painting (specification: 40 mL), provided by Chengdu Chaojl Technology Co., Ltd. (lot number 070501).METHODS: A total of 16 healthy Sprague Dawley rats aged 20 to 23 days were selected. Full linear skin incisions were operated in aseptic condition. After operation, the experimental group (right side) was sprayed medical invisible antimicrobial film 0.5 mL/time, once a day, for totally 3 days. The control group (left side) received an equal volume of 0.9% sodium chloride injection, with natural cure.MAIN OUTCOME MEASURES: At 3, 7 and 14 days following surgery, incision skin specimens were obtained, and subjected to hematoxylin-eosin staining and Masson staining was applied to observe wound healing and the formation of scar, then the scar area was analyzed.RESULTS: The scar relative mean area of control group was 154 069±51 356 and the experimental group was 98 200±34 719 on the postoperative 14~(th) day. The two groups were significantly different (P < 0.05). At 14 days following surgery, optical microscope showed that the experiment group had less collagen fibers and fibroblast accumulation. At 3 days, compared with the control group, the experimental group had less epithelization period, more granulation tissue and less inflammatory cell infiltration.CONCLUSION: The medical invisible antimicrobial film has inhibitory effect of the formation of operative incision scar, and no influence on wound healing of operative incision.

Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease (PD) recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks(SS-16) tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr (H-Y) rating, and cognitive function level (Montreal Cognitive Assessment) was analyzed.Results (1)The prevalence of olfactory dysfunction in PD group (83.3%) was significantly higher than that in control group (21.2%).The Sniffin’ Sticks test showed that the odor threshold score (6.6 ±3.2, P=0.000), odor discrimination score (6.6 ±3.3, P=0.000), 16 kinds of odor identification score (6.8 ±2.4, P=0.000) in PD group were significantly lower than those in control group.( 2 ) When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.( 3 ) The olfactory score in PD group was positively correlated with cognitive function (r=0.243, P=0.046), and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age (r=-0.270, P=0.018), but positively correlated with cognitive function (r=0.281, P=0.014).Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .

Objective To investigate the value of MRI in thmmbolytic thempy of hyperacute cerebral arterial thrombosis.Methods One hundred and sixteen patients with acute cerebral arterial thrombosis were recruited.plain CT and multi.modal MRI were performed in all patients.Thirty-three patients with hyperacute cerebral infarction were treated bv recombinant tissue plasminogen activator(rt-PA) and followed-up periodically using MRI.Results The 33 patients with thrombolysis selected by MRI demonstrated clinical improvement.90 d moclified Rankin scale scores(mRs)were less than 2 and life quality Barthal indexes(BI)were from 80 to 100.The complication included one asymptomatic parenchymal hematoma(PH1)one weeks after thrombolytic therapy and 4(12.2%)hemorrhagic infarction(HI)6 to 24 hours after thrombolytic therapy.Condusions MRI has significant clinical value for the screening and follow-up of intravenous thrombolytic therapy of hyperacute ischemic stroke.MRI-based thrombolysis is a safe and effective method for hyperacute ischemic stroke.

Objective:To explore the characteristics of the sleep structures of patients with both chronic insomnia and obstructive sleep apnea (OSA) in plateau area.Methods:Polysomography Alice 5 was applied to 23 patients with primary chronic insomnia [insomnia group, age (48.2±9.9) years], 22 patients with both chronic insomnia and OSA [comorbidity group, age (46.8±8.9) years], who both came from Qinghai Red Cross Hospital between January, 2014 to June, 2015 and 20 subjects with normal sleep [healthy group, age (46.2±7.1) years] in plateau area (mainly in Xining, altitude 2 250 meters or above) to compare and explore their sleep structures by the whole night sleep monitoring in the sleep monitoring room. The sleep structures were compared according to the American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events.Results:Compared to healthy group, insomnia group and comorbidity group both had significantly lower sleep efficiency [(62.4%±16.7%), (59.8%±16.0%) vs (80.9%±8.8%)], non-rapid eye movement (NREM) phase 2 sleep ratio [(37.9%±12.2%), (36.2%±12.5%) vs (49.7%±6.2%)] and rapid eye movement (REM) sleep ratio [(7.7%±4.0%), (6.5%±4.0%) vs (12.5%±4.6%)] (all P<0.05); comorbidity group had a significantly higher oxygen desaturation index than insomnia group and healthy group [(30.8±29.2) vs (7.9±7.5), (5.9±2.7) times/h] ( P<0.05); insomnia group′s sleep latency of NREM3 stage was significantly longer than comorbidity group and healthy group [(148.9±113.6) vs (89.3±51.8), (59.1±40.3) min] (both P<0.05). Conclusion:Patients with both chronic insomnia and OSA and patients with chronic insomnia only in plateau area have different sleep structures, and both of their sleep quality are lower than the people with normal sleep; patients with both chronic insomnia and OSA could enter deep sleep more quickly after sleep onset.

Objective To explore the effects of different phenotypes macrophages(Mφs)on the proliferation,mi-gration and osteogenic differentiation of periodontal ligament stem cells(PDLSCs).Methods PDLSCs were isola-ted and cultured by tissue block method.Tohoku Hospital Pediatrics-1(THP-1)cell line was stimulated to activate into unpolarized Mφs(M0),then induced to polarize into type Ⅰ Mφs(M1)and type Ⅱ Mφs(M2).Quantitative real-time PCR(qPCR)detected the inflammatory factors tumor necrosis factor α(TNF-α),interleukin(IL)-1 β,IL-6,IL-10 and transforming growth factor-β(TGF-β)mRNA expression level.After collecting culture superna-tants with different phenotypes,PDLSCs were stimulated,native control(NC)group did not receive the culture su-pernatant of Mφs.The effects of PDLSCs proliferation were assessed via Methylthiazolyldiphenyl-tetrazolium bro-mide(MTT)assay,while scratch assays were employed to evaluate their migration.Western blot was utilized to analyze the protein expression of Runt-related transcription factor 2(RUNX2)and alkaline phosphatase(ALP).Additionally,Alizarin Red staining was performed to investigate the deposition of calcified nodules in PDLSCs.Re-sults qPCR showed the relative expression of TNF-α,IL-1 β and IL-6 in M1 Mφs were higher than those in M0 and M2 Mφs(P＜0.05),and the relative expression of IL-10 and TGF-β in M2 Mφs were higher than those in M0 and M1 Mφs(P＜0.05);Western blot showed the expression of RUNX2 and ALP proteins in PDLSCs in M0 and M2 groups was higher than those in the NC group(P＜0.05),Alizarin Red staining showed increased calcified nodule deposition in PDLSCs in M0,M1 and M2 groups compared to the NC group;MTT assay showed the prolifer-ation of PDLSCs in the M0 and M1 groups was suppressed compared to the NC group(P＜0.05);and scratch ex-periment showed the migratory capacity of PDLSCs in the M1 and M2 groups was stronger than that in the NC group.Conclusion M0 and M1 Mφs inhibit PDLSCs proliferation,M1 and M2 Mφs promote PDLSCs migration,and all types of Mφs promote osteogenic differentiation of PDLSCs.

Objective: This study aimed to explore the role of SGK-1 in the occurrence of temporomandibular joint(TMJ) osteoarthritis(TMJ-OA). Methods: Sixteen rats were randomly divided into Control group(Control group) and TMJ-OA group(TMJ-OA group), and TMJ-OA group was injected with sodium iodoacetate(MIA) intra articular cavity while Control group was injected with 0.9% sodium chloride solution. Pain behavior was assessed by measuring the head withdrawal threshold(HWT) with a von-Frey apparatus. Hematoxylin-eosin(HE) and Safranin O-fast green stains were used to observe the histological structure changes of the condyle of TMJ-OA rats. Real-time PCR was performed to exam the expression levels of mRNA of SGK-1, MMP-13, IL-1β, COX-2 in mandibular condylar cartilage(MCC). HE stain was used to observe the histological structure changes of the trigeminal ganglion(TG) of TMJ-OA rats. Real-time PCR was performed to exam the expression levels of mRNA of SGK-1, COX-2 in TG. Results: MIA injection induced typical OA-like lesions in the TMJ within 28 days. Administration of MIA led to the significant decrease in HWT, disordered of the condyle cartilage and subchondral bone structure, demyelination aggravated of nerve fibers in TMJ rats. Compared with rats in Control groups, the expression levels of SGK-1 in MCC and TG of rats in TMJ-OA group were upregulated. Conclusion In the pathological process of TMJ-OA, SGK-1 may plays an important role not only in cartilage structural damage but also in pain transmission.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Humans ; Venous Thromboembolism/prevention & control* ; Anticoagulants/therapeutic use* ; Pulmonary Embolism ; Patients ; Hospitalization ; Risk Factors