Child ; Female ; Humans ; Lipoma ; complications ; Pharyngeal Neoplasms ; complications ; Polysomnography ; methods ; Sleep Apnea, Obstructive ; etiology

Objective To study the screening value of color doppler flow imaging (CDFI) for gastroesophageal reflux(GER).Methods Through the window of left lobe liver, the abdominal esophageal length,the phenomenon of GER and the frequency of GER were detected by CDFI in 55 children with GER and 55 control group.Results Abdominal esophagus was identified by CDFI in every children. The abdominal esophageal length was shorter in refluxers than that in control group. A significant correlation was found between its length and the age of control group.To diagnose GER with CDFI ,its accuracy was 98.18%,and its specificity was 76.36%.Conclusions Visualization and measurements of the abdominal esophagus are readily achieved with CDFI in children.Abdominal esophageal length is shorter in refluxers than that in control group. CDFI is a rapid method of screening GER.

Objective To study whether gastric liquid emptying is delayed in children with gastroesophageal reflux and its clinical significance. Methods At different times after meal, the gastric antral diameters were measured by real - time ultrasonography in 55 children with gastroesophageal reflux and 55 controls. Results At 20 min,60 min after meal , there was a significant difference in gastric emptying rate between case groups and control groups, respectively(P

Objective To investigate the expression of Fas/FasL in children with aplastic anemia(AA) and its clinical significance.To explore the pathogenesis of AA.Methods CD34+ cell counts and the expression of Fas/FasL in 12 children with severe AA(SAA),18 with chronic AA(CAA)and 10 normal children were detected by flow cytometry combining monocolon antibody.Results The expression of Fas in children with AA were significantly higher than that in control group(P0.05).Conclusions Fas/FasL systeam take part in inducing CD34+ cell apoptosis.This may contribute to understanding the decrease number of stem cells and bone marrow failure.

Objective To investigate the effect of the modified wrist-hand orthosis on the spasm and function of wrist-hand in hemiplegic patients. Methods 56 patients with hemiplegia after stroke were divided into observation group (n=28) and control group (n=28). All the patients received routine rehabilitation, including physical therapy, occupational therapy, and Hufschmidt therapy. The observation group wore modified wrist-hand orthosis 4-8 hours a day after the treatment, with interval of 15 min per 30-60 min. All the patients were assessed with modified Ashworth Scale (MAS), simple Fugl-Meyer Assessment (FMA) and active range of motion (AROM) of flexion, extension, radial deviation and ulnar deviation of wrist before and 4 weeks, 8 weeks and 12 weeks after treatment. Results There was no significant improvement in both groups 4 weeks after treatment, nor difference between groups. The scores of MAS and FMA improved 8 weeks after treatment in both groups (P<0.05), and improved more in the observation group than in the control group (P<0.01). While the AROMs improved in the observation groups (P<0.05), and the AROM of extension was more than that of the control group (P<0.01). 12 weeks after treatment, the scores of MAS and FMA improved further in the observation group (P<0.01), and improved more than those of the control group (P<0.01). The AROMs of flexion, extension and radial deviation improved more in the observation group than in the control group (P<0.05). Conclusion The modified wrist-hand orthosis can obviously relieve the spasm of wrist-hand flexor in patients with hemiplegia after stroke, and promote the motor function.

Objective:To investigate the changes of gene or protein expression and activity of matrix metalloprotein9 (MMP9) and tissue inhibitor ofmetalloproteinasel (TIMP1) in the carotid artery (CA) of 4 wk hindlimb unweighted rat.Methods:A 4 weeks(wk) hindlimb unweighted (HU) rat model was used to simulate the effect of weightlessness on the cardiovascular system.Transmission electron microscopy was used to detect the content of ECM.Reverse transcriptase polymerase chain reaction(RT-PCR) was conducted to measure the mRNA content MMP and TIMP1.Immunohistochemistry and Western blot technique were used to measure the protein abundance.Gelatin zymography was carried out to detect the activity of MMP9.Results:Compared to the control group (CON),the area of ECM was enhanced (P＜0.05) and the content of collage fiber was increased (P＜0.05) in the CA of HU rats;moreover,HU did not affect the mRNA expression of MMP9,but significantly reduced the protein content (P＜0.05) or enzymatic activity (P＜0.05).Accordingly,the mRNA or protein expression of TIMP1 in the CA was significantly increased by HU (P＜0.05).Conclusion:Simulated weightlessness caused imbalance between MMP and TIMP1 expression,which might contribute to the ECM aggregation and stiffness of CA.

OBJECTIVETo evaluate the clinical effects of posterior spinal transpedicular wedge osteotomy for kyphosis due to delayed osteoporotic vertebral fracture in elderly.

METHODSFrom July 2009 to February 2014,26 patients with kyphosis caused by delayed osteoporotic vertebral fracture were treated with transpedicular wedge osteotomy. There were 10 males and 16 females,aged from 55 to 75 years old with an average of 67 years. There were 1 osteotomy in thoracic vertebra,21 osteotomies in thoracolumbar vertebrae and 4 in lumbar vertebrae. Total 29 vertebrae were involved, 23 cases with single vertebral fracture and 3 cases with double vertebral fractures. Preoperative Cobb angles were 32°~51° with the mean of (42.00 ± 4.75) ° and VAS scores were 6 to 9 points with an average of (8.40 ± 0.75) points. According to the Frankel grade of spinal cord function, 4 cases were grade D and 22 cases were grade E. Intraoperative bleeding, operation time and perioperative complications were recorded, and improvements of Cobb angle were evaluated by X-rays. VAS score and Frankel grade were respectively used to evaluate the pain and nerve function.

RESULTSThe average operation time were 155 min (ranged, 120 to 175) and the mean intraoperative bleeding were 1 100 ml (ranged,800 to 1 500). Postoperative at 2 days, Cobb angle and VAS score were (9.60 ± 2.50) ° and (4.00 ± 1.00) points, respectively, ranged from 5° to 15° and 1 to 5 points. VAS score and Cobb angle improved obviously compared with preoperative (P < 0.05), and the improvement rate of Cobb angle was 76%. Frankel grade of 1 case changed from grade E to C, and the others did not become worse. The follow-up period ranged from 3 to 24 months with an average of 16.4 months. At the final follow-up, Cobb angles and VAS score were (11.00 ± 3.50)° and (4.40 ± 1.25) points, respectively, ranged from 5° to 19° and 1 to 6 points. The patient whose Frankel grade E changed to C at 2 days after surgery and changed to grade D at the latest follow-up. Vertebral body fracture below the fusion level happened in 1 case at 3 months after surgery, vertebral body fracture above the fusion level happened in 1 case at 5 months after surgery, and their chest pain symptoms were relieved after symptomatic treatment and anti osteoporosis treatment. All osteotomy levels obtained fusion which confirmed by X-ray and no internal fixation loosening and breakage were found.

CONCLUSIONThe clinical effect of posterior transpedicular wedge osteotomy for kyphosis due to delayed osteoporotic vertebral fracture was satisfactory, but manipulation during the operation should be cautious and prevent adjacent vertebral body fracture should be pay attention to prevent.

Aged ; Female ; Humans ; Kyphosis ; etiology ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; complications ; surgery ; Osteotomy ; methods ; Spinal Fractures ; complications ; surgery ; Visual Analog Scale

Breast Neoplasms ; genetics ; metabolism ; Female ; Gene Expression Profiling ; Humans ; Male ; Oligonucleotide Array Sequence Analysis ; methods

Objective To study the correlation between blood glucose variability and TOAST type of patients with acute ischemic stroke and provide new evidence which can improve the prognosis of ischemic stroke.Methods One hundred and forty-three hospitalized patients with acute ischemic stroke from August 2013 to August 2014 were included.All patients were estimated about the general state of health and performed laboratory examinations and other auxiliary examinations.Then the TOAST type of all cases was classified.The 24-hour blood glucose monitoring was done to the patients to calculate the blood glucose variability.One hundred and forty-three cases were divided into blood glucose variability group ( standard deviation of glucose ( GluSD )≥1.4 mmol/L, 85 cases ) and control group ( GluSD <1.4 mmol/L, 58 cases) according to glucose variability.We estimated the neurologic impairment of the patients with the US National Institutes of Health Stroke Scale ( NIHSS) and the activities of daily living with Barthel index.The relation between blood glucose variability and the prognosis of ischemic stroke was analysed with multivariate analysis.Results Differences were significant in age, history of diabetes and NIHSS score between blood glucose variability group and control group.The degree of neurologic impairment of large artery atherosclerosis (LAA) group (moderate and severe neurologic impairment:43/53(81.0%)) and cardio-aortic embolism ( CE) group ( moderate and severe neurologic impairment:15/17 ) was more serious than that in small artery occlusion ( SAO) group ( moderate and severe neurologic impairment:6/71 ( 8.5%) ) , especially in CE group.The differences were significant (χ2 =7.043,P<0.05).Blood glucose variability in patients with LAA was more obviously than that in other patients.NIHSS score and activities of daily living of the patients estimated on admission and after 2 weeks were not different in the blood glucose variability group, but the difference was significant in control group.The poor prognosis in blood glucose variability group was 2.821 times that in control group ( 95% CI 1.880 -4.233 ).Conclusions The people sufferd ischemic stroke with old age, diabetes or severe case are more vulnerable to abnormal blood glucose variability.Abnormal blood glucose variability is an independent risk factor for acute ischemic stroke and induces difficulty to recovery and poor prognosis.