Objective To investigate the clinical effect of pedicle screw internal fixation with different surgical approach in the treatment of thoracolumbar vertebral fractures. Methods Fifty?three cases with thoracolumbar vertebral fracture without nerve injury were selected as our subjects,who were hospitalized in the Central Hospital of Chaoyang from January 2008 to December 2013. They were randomly divided into observation group(27 cases) and control group(26 cases). The patients in the observation group were treated with pedicle screw internal fixation with Wiltse paraspinal approach and the patients in the control group were treated with pedicle screw internal fixation with traditional posterior open approach. The duration of operation,intraoperative blood loss,volume of drainage and length of hospital stay of all patients were recorded and the ratio of anterior vertebral body height to normal height before and after operation was compared between the two groups. Visual analog scores( VAS) for pain severity and Cobb’ s angle of the vertebrae was compared between the two groups 1 year after operation. Results The duration of operation and length of hospital stay of patients in both groups had no statistically significant differences ( P>0. 05 ) . The intraoperative blood loss and volume of drainage in observation group were less than that in control group respectively((146. 3±25. 1) ml vs. (240. 2±28. 7) ml, (73.1±15.3) ml vs. (150.5±20.1) ml;P=0.034,0.023).The ratio of anterior vertebral body height to normal height 1 week after operation was higher than that before operation in the observation group ( ( 93. 1 ±5.1)% vs. (70.3±8.6)%,P=0.048) and in the control group((93.0±6.0)% vs. (71.8±9.8)%,P=0. 049),the difference between two group had no statistically significant(P>0. 05). The Cobb′s angle of the vertebrae 1 year after operation was less than that before operation in the observation group((10. 10±4. 00)° vs. (19. 10±7. 81)°,P=0. 045) and in the control group ((9. 97±3. 78)° vs. (18. 87±6. 90)°,P=0. 045),the difference between two group had no statistically significant(P>0. 05). The VAS for pain severity 1 year after operation was less than that before operation in the observation group(1. 1±0. 5 vs. 6. 0±0. 9,P=0. 023) and in the control group ( 1. 7 ± 0. 6 vs. 5. 9 ± 0. 7, P= 0. 038 ) , the difference between two group had statistically significant( P=0. 046) . Conclusion Pedicle screw internal fixation with Wiltse paraspinal approach in the treatment of thoracolumbar vertebral fractures without nerve injury has advantages with traditional posterior open approach in less trauma, less bleeding, rapid recovery and reduces the incidence of postoperative lumbar pain. The treatment has a good clinical effect and is worthy of clinical application.

Bronchopulmonary dysplasia(BPD)is the main cause of chronic respiratory diseases in preterm infants.The research on the prophylaxis and treatment of BPD has been a concern of neonatologists because of its high incidence and poor prognosis in preterm infants.Glucocorticoid is a major therapy in the treatment of BPD because the pathological changes of BPD are characterized by persistent lung inflammation.Until now, a large number of clinical studies including different types and administration methods of glucocorticoids have been conducted.Compared with other types of glucocorticoids, low-dose and short-course dexamethasone has its unique advantages in the treatment of BPD.This article reviews the role of inflammation in the pathogenesis of BPD and the research progress of glucocorticoids in the prophylaxis and treatment of BPD.

Objective The aim of this study was to examine plasma levels of CD40 ligands (CD40L) and pregnancy-associated plasma protein-A in patients with angiography type Ⅱ lesions (representing plaque rupture with or without thrombosis), and to evaluate the role of PAPP-A in the development of plaque disruption. Methods The morphology of the plaques in 68 patients was studied and analyed by means of coronary angiography. According to the morphology of the plaques, the patients were divided into type Ⅰ group (smooth borders, n=19), type Ⅱ group (irregular lesions, n=33), and type Ⅲ group (long lesions, n=16). The plasma level of CD40L, PAPP-A, creatine kinase (CK), and MB isoenzyme of CK (CK-MB) was measured in all the patients. Results Mean plasma CD40L [(3.21?2.08)mg/L] in type Ⅱ group was significantly higher than that in the type Ⅰ group [(1.03?0.98)mg/L, P

Objective To study the complications and the outcome of different type of twin pregnancy. Methods Three hundred and thirty two cases of twins from 1981 to 2000 were analyzed retrospectively. Results The incidence of twins is 8.63%.The common complications were pregnancy induced hypertension, premature rupture of fetal membranes, anaemia, premature labor and postpartum hemorrhage. There were no differences between the monozygotic twins and dizygotic twins in the incidences of these complications. The incidence of one fetal death in monozygotic twins was higher than that of the dizygotic twins (P

Objective To observe the relationship between pregnancy-associated plasma protein-A (PAPP-A), C-reactive protein (CRP) and acute coronary syndrome (ACS). Methods Sixty-eight patients with coronary artery disease, who were confirmed by angiography, were enrolled in this study. Among them, there were 43 cases with ACS and 25 cases with stable angina. At the same time, randomly selective 20 healthy subjects served as control group. Plasma PAPP-A and CRP levels were measured by using untrasensitive immunosorbent assay (ELISA). Results The plasma levels of PAPP-A and CRP were significantly higher in ACS patients than those in control group (PAPP-A: 17.9?8.7mIu/L VS 7.1?4.2mIu/L, P1, which indicated both were the risk factors of ACS. Conclusion The plasma levels of PAPP-A and CRP increased in ACS patients, and both PAPP-A and CRP were independent risk factors of ACS.

BACKGROUND: Tonifying kidney is the main method to treat aging of nervous system, which is characterized by decreasing density of nerve cells,cell aging and deposition of lipofuscin granule in the cytoplasm of nerve cell.OBJECTIVE: To investigate the effect of nourishing kidney and tonifying brain on density and ultrastructural of nerve cell in hippocampal CA1 and CA3 area of aging mouse. DESIGN: Completely randomized and controlled study.SETTING: Institute of Traditional Chinese Medicine of Hunan Province.MATERIALS: The experiment was completed at the Pharmacological Laboratory of Institute of Traditional Chinese Medicine of Hunan Province between September 2000 and November 2003. Totally 30 Kunming mice with 11-month old were selected. Solution of yishen jiannao Ⅰ (zishen prescription) was provided by Agent Laboratory of Institute of Traditional Chinese Medicine of Hunan Province (including 15 g shouwu, 15 g sangshen, 15 g gouqizi, 6 g wuweizi, 30 g danshen, 30 g gegen, 10 g honghua,10 g shichangpu, 10 g yujin, 10 g yuanzhi, 10 g shanzha and scorpion).Scorpion was crushed into power. The rest drugs were decocted with water twice, mixed together and filtered, then the powder of scropion was added.The raw material was 1.0 g/mL.METHODS: Thirty mice were randomly divided into 3 groups with 10 in each group. Mice in control group were given distilled water, those in zishen prescription group were given 20.0 g/kg zishen prescription, and in vitamin E group were given 40.0 mg/kg vitamin E. All mice were perfused with 20 mL/g, once a day for 4 weeks. After 1 hour of the last medication, mice were sacrificed at once at the drugged state. Cranium of mice was sheared and the hippocampal tissue was taken out. Numbers of nerve cells in CA1 and CA3 area were calculated under the microscope to calculate the density of nerve cell.MAIN OUTCOME MEASURES: ① Density of nerve cell in cerebral hippocampus of mice in each group; ② Ultrastructure of nerve cell in cerebral hippocamp us of mice in each group.RESULTS: Totally 30 mice entered the final analysis. ① Density of nerve cell in hippocampal CA1 and CA3 area of brain: Density in zishen prescription group and vitamin E group was higher than that in control group [CA1: (3 707±495), (3 812±281), (257±372) mm-2; CA3:(2 746±262),(2 397±366), (1 992±307) mm-2, t=2.68-8.30, P ＜ 0.05-0.01]. ② Aging of mitochondrion was decreased, deposition of lipofuscin and aging of lysosome in cytoplasm were reduced in zishen prescription group and vitamin E group.CONCLUSION: Granule of nourishing kidney and tonifying brain can defer density decrease of nerve cell and aging of cell in hippocampla area of mice' brain.

Humans ; Mandibular Diseases ; prevention & control ; Osteoradionecrosis ; prevention & control ; Radiotherapy ; adverse effects ; Tooth Extraction

This paper reports a case of melanotic neuroectodermal tumor of infancy (MNTI)arising in the maxilla of a 3-month-old male infant.The treatment included surgical excision of the lesion with safe margin,curettage of the maxilla and removal of associated developing tooth bud.Microscopically,it proved to be a dual tumor with small,neuroblastic-like cells and larger epithelial cells.Immunohistochemical staining demonstrated epitheloid cells HMB45(+),EMA(+),CK(+);neuroblast-like cells NSE(+),GFAP(+),S-100(+),but both cells Vim(+),CD45(-),Myogenin(-).The 18-mouth follow-up showed no recurrence or metastasis.The related literature was re-viewed.

Objective To investigate the antibiotic resistance of extended-spectrum-β-1actamases (ESBLs)-producing Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) isolates and the risk factors of bloodstream infections caused by these strains.Methods Clinical data of 131 patients with E.coli or K.pneumoniae-induced bloodstream infections admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University during September 2009 and June 2014 were retrospectively analyzed.Species identification and antimicrobial susceptibility test were performed by Vitek 2 system,and ESBLs production was tested by standard disk diffusion method.Logistic regression analysis was performed to identify the risk factors of bloodstream infections induced by ESBLs-producing strains.Results Among 131 patients,65 were infected with ESBLs-producing strains,and 66 were infected with non-ESBLs-producing strains.The resistance rates of ESBLs-producing strains were above 50％ for penicillin,aztreonam and third/fourth generation cephalosporins,which were significantly higher than those of non-ESBLs producing strains.The resistance rates of ESBLs-producing E.coli and K.pneumoniae to carbapenems and piperacillin/tazobactam were 0-2.0％,2.3％ and 0-14.3％,26.7％,respectively.The univariate analysis revealed that patients with exposure to cephalosporins in recent 3 months (x2 =18.322,P ＜ 0.01),prior infection with ESBLs-producing strains (x2=14.610,P＜0.01),indwelling catheter in recent 3 months (x2 =13.016,P ＜ 0.01),history of hospitalization in recent 3 months (x2 =11.269,P ＜ 0.01),exposure to quinolones in recent 3 months (x2 =10.638,P ＜ 0.01),nosocomial infection (x2 =8.205,P ＜ 0.01),history of indwelling deep venous catheter or percutaneous central catheter in recent 3 months (x2 =4.817,P ＜ 0.05) and exposure to glucocorticoid hormone in recent 3 months (x2 =4.265,P ＜ 0.05) were associated with infection of ESBLs-producing strains.Multivariate Logistic regression analysis revealed that exposure to quinolones in recent 3 months (OR =6.851,P ＜ 0.01),prior infection with ESBLs-producing strains (OR =6.344,P ＜ 0.01),exposure to cephalosporins in recent 3 months (OR =3.719,P ＜ 0.01),and indwelling catheter in recent 3 months (OR =3.180,P ＜ 0.05) were independent risk factors for ESBLs-producing E.coli or K.pneumoniae infection.Conclusions ESBLs-producing E.coli or K.pneumoniae isolates are highly resistant to most antibiotics,and multidrug-resistance is common.Carbapenems were still the most effective antibiotics against ESBLs-producing E.coli or K.pneumoniae infection.Rational use of cephalosporins and quinolones,strictly following aseptic technique in operation,strict use of indications for indwelling catheterization,and completely eradicating ESBLs-producing strains in previous infections may be helpful in reducing bloodstream infections by ESBLs-producing E.coli or K.pneumoniae.

ObjectiveTo determine whether the inhibition of caveolin-1 tyrosine residues 14 (Cav-1-Y14) phosphorylation with protein tyrosine kinase inhibitors (PP2) will upregulate heme oxygenase-1 (HO-1) activity to protect against ventilation induced lung injury in vivo of an animal model.Methods Fifty-four male Sprague-Dawley (SD) rats were randomly divided into nine groups (eachn = 6). Group A served as normal control group, in which rats did not receive ventilation but tracheotomy. Groups B1 and B2 received lung protective ventilation respectively for 1 hour or 2 hours. Groups C1 and C2 received high tidal volume (40 mL/kg) ventilation for 1 hour or 2 hours, respectively. The group D1 or D2 also received high tidal volume ventilation for 1 hour or 2 hour respectively, but they were given PP2 1 hour before high tidal volume ventilation. The groups E1 and E2 also received high tidal volume ventilation respectively for 1 hour or 2 hours, but tyrosine kinase inhibitor PP2 and HO-1 inhibitor zinc protoporphyrinⅨ(ZnPPⅨ) were given to animals 18 hours before high tidal volume ventilation. All the animals were sacrificed after ventilation, and the specimens of lung tissues and bronchoalveolar lavage fluid (BALF) were harvested. Then the changes in pathology of lung tissue was observed, and diffuse alveolar damage scores (DAD) were calculated, myeloperoxidase (MPO) activity was measured by colorimetric analysis, lung wet/dry ratio (W/D) was estimated. The expressions of phosphorylated caveolin-1 (P-Cav-1-Y14), caveolin-1 (Cav-1) and HO-1 were determined by Western Blot. The expressions of high mobility group B1 (HMGB1) and advanced glycation end product receptor (RAGE) in lung tissues were assayed with immunohistochemistry staining. The levels of tumor necrosis factor-α(TNF-α) in BALF were measured by enzyme linked immunosorbent assay (ELISA).Results There was no significant difference in all the parameters between group A and groups B. Compared with group B1, DAD score, W/D ratio, the activity of MPO and the concentration of TNF-α in BALF in group C1 were significantly increased [DAD score:7.97±0.59 vs. 0.55±0.13, W/D ratio: 5.70±1.61 vs. 5.04±0.63, MPO (U/g): 1.82±0.14 vs. 0.77±0.26, TNF-α(ng/L): 370.10±29.61 vs. 54.38±8.18, allP< 0.05], and the injury in ventilation 2 hours group was more serious than that in ventilation 1 hour group. Compared with groups C, all the parameters in groups D were significantly decreased. The parameters in groups E were significantly higher than those in groups A, B, and D, but no significant difference was found as compared with groups C. Compared with groups B, the protein expressions of Cav-1 and P-Cav-1-Y14 (gray value) in groups C were significantly increased (1 hour: 1.49±0.02 vs. 1.26±0.13, 1.34±0.02 vs. 0.87±0.04;2 hours: 1.58±0.02 vs. 1.27±0.27, 1.31±0.01 vs. 0.95±0.02, allP< 0.05), and the expression of HO-1 protein (gray value) was significantly decreased (1 hour: 0.59±0.02 vs. 1.10±0.01, 2 hours: 0.49±0.01 vs. 1.20±0.02, both P< 0.05). No significant difference in Cav-1 protein expression between groups D as well as groups E and groups C. The protein expression of P-Cav-1-Y14 in groups D and E was significantly lower than that in groups C. The protein expression of HO-1 in groups D was significantly higher than that in groups C, but the phenomenon was not found in groups E as compared with groups C. Compared with group A, the positive expression of HMGB1 and RAGE in lung tissue in groups C and E was significantly increased, but no significant difference was found between groups B as well as groups D and group A.Conclusion Cav-1-Y14 phosphorylation is the key factor for ventilator induced lung injury, which can not only lead to a decrease in vascular barrier function, but also inhibit the activity of HO-1 enzyme, thus further aggravates inflammatory injury of the lung as induced by mechanical ventilation.