Brain ; physiology ; Child ; Child Behavior ; physiology ; Child Development ; physiology ; Humans ; Infant ; Motor Activity ; physiology ; Motor Skills Disorders ; diagnosis

Objective To study the endoscopic anatomy of operative fissures in the sellar region related to pterional key-hole approach and to provide the anatomic basis for endoscope-assisted microneuro-surgery in the region. Methods Fifteen cadaver heads were dissected via pterional key-hole approach and the five operative fissures(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ) were studied with both microscope and endoscope, by which the outcomes observed were recorded and compared. Results The basic information obtained by the pterio-nalkeyhole approach was comparable to that of the classic ptefional approach. According to the anatomic guideposts under neuroendoscope, the microstructures of the five fissures and Willis' circle would be well demonstrated. It is better to display the various anatomic structures in sellar region by neuroendoscope rather than microscope, particularly some important microstructures. Angled endoscope can be used to inspec thidden but important structure behind the arteries and nerves. Conclusion According to the anatomic guideposts, an endoscopy can be used to enhance the visible field of an operative microscope related to pterional key-hole approach. The endoscope-assisted microsurgery can reduce complications and injury of the important structures and increase the curative effect on the lesions in the sellar region.

OBJECTIVE:To systematically review the efficacy and safety of escitalopram versus paroxetine in treatment of se-nile patients with depression in China,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP,Wanfang database,CBM database,randomized controlled trials(RCT)of escitalopram(test group)versus paroxetine (control group) in the treatment of senile patients with depression in China were collected. After quality evaluation and data ex-tract,Meta-analysis was performed by using Rev Man 4.2 statistics software. RESULTS:A total of 14 RCT were included,involv-ing 1 148 patients. Results of Meta-analysis showed there was no significant difference in the cure rate[OR=1.20,95%CI(0.93, 1.53),P=0.16],significant effective rate[OR=1.23,95%CI(0.94,1.61),P=0.12],the incidences of headache[OR=0.81,95%CI (0.40,1.65),P>0.05],the incidences of tachycardia [OR=0.37,95%CI(0.09,1.52),P>0.05],the incidences of insomnia [OR=1.26,95%CI(0.33,4.82),P>0.05] and the incidences of tremor [OR=0.31,95%CI(0.04,2.24),P>0.05] between test group and control group;the incidences of xerostomia[OR=0.50,95%CI(0.31,0.80),P<0.05],the incidences of nausea[OR=0.49,95%CI (0.36,0.66),P<0.05],the incidences of sweating [OR=0.31,95%CI(0.15,0.62),P<0.05],the incidences of constipation[OR=0.31,95%CI(0.15,0.64),P<0.05],the incidences of dizziness[OR=0.38,95%CI(0.20,0.72),P<0.05] and the incidences of an-orexia[OR=0.45,95%CI(0.21,0.99),P<0.05] in test group were significantly lower than control group,there were significant dif-ferences in 2 groups. CONCLUSIONS:The efficacy of escitalopram and paroxetine is similar in the treatment of senile patients with depression,however,the safety of escitalopram is better than paroxetine. Due to the limit of methodological quality and sam-ple size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.

[Objective]To obtain the normal linear parameters of different resection levels of normal proximal tibia in Chinese people, and discuss the influence of the gender and resection level on the design of the tibia prosthesis. [Methods]Thirty-six normal Chinese people (36 left knees, 18 males and 18 females), with an average age of 43 years (range 18～55 years) were enrolled in this study.Original CT image data were used to set up three-dimensional model of Chinese normal knees.The related linear parameters of different proximal tibia sections were measured and compared.[Results]Parameters of mediolateral (ML) ,medial and latera anteroposteriordimensions(MAP/ LAP) and the aspect ratio(AP/ML) of the resect proximal tibia surface were obtained. The parameters were confirmed by statistics analysis.[Conclusion]The geometry and anatomy of the knee in Chinese people have significant differences from the western people.The prosthesis designed by western people should be choosen carefully.Sex and resection levels should be taken into account in designing tibia prosthesis and or choosing the imported prosthesis in the total knee arthroplasty.

Objective To explore the changes of IL-12,IL-18,IL-10 in the pleural fluid and serum of tuberculosis (TB)patients during the disease course.Methods 60 TB patients were selected as test subjects in this study,all patients with pleural fluid and serum were taken for testing.The pleural fluid and serum IL -12,IL -18 IL-10 changes,more naive patients and patients with pleural effusion retreatment and serum IL -12,IL -18,IL -10 content differences were observed and analyzed.Results Both in the initial treatment or retreatment group of pa-tients,the IL -12 and IL -10 levels in pleural effusion were significantly higher than those in the serum,the differ-ences were statistically significant(all P =0.000),and IL -18 content of pleural effusion in a little early treatment group was lower than that of the serum,the differences was not statistically significant(P =0.151),and the IL -12 and IL -10 contents in the pleural fluid and serum were higher than the retreatment of patients previously untreated patients.The IL -12 level in pleural effusion of Ⅱ type patients was (3 025.80 ±1 324.75)pg/mL,which in the ser-um was (498.84 ±326.73)pg/mL,which in the pleural effusion was significantly higher than in the serum(P =0.020),and the IL -12 levels in pleural effusion of Ⅲ -TB and Ⅳ type TB patients were also significantly higher than those in the serum,the differences were statistically significant(all P =0.000).The IL -18 level in pleural effu-sion of Ⅱ type patients was (1 735.54 ±872.65)pg/mL,which in pleural effusion of Ⅲ patients was (754.63 ± 426.87)pg/mL,in pleural effusion of Ⅳ patients was (655.19 ±412.63)pg/mL or so,and serum IL -18 levels in patients with different types of pleural TB had no obvious rule,the differences were not statistically significant(P =0.998 4).The IL -10 level in pleural effusion of Ⅱ type patients was (29.35 ±8.46)pg/mL,which in pleural effu-sion of Ⅲ patients was (183.49 ±56.76)pg/mL,which in pleural effusion of Ⅳ patients was (162.95 ±52.43)pg/mL,the IL -10 content of pleural in different clinical types of TB patients was different,which were significantly high-er than those in the serum,the differences were statistically significant(P =0.000).Conclusion TB patients in the disease,pleural effusion IL -12 and IL -10 are significantly higher than the serum,and retreatment of patients with pleural effusion IL -12,IL -10 levels are significantly higher than the untreated patients,but IL -18 in serum has no significant variation in pleural fluid.

Objective To explore the microneurosurgical treatment of recurrent intra-spinal canal tumors. Methods The clinical data on the microsurgical parameters, operative procedures, operative efficacy and post-operative complications of 16 cases with recurrent intra-spinal canal tumors from June 1993 to June 2002 were reviewed retrospectively. Results Under the operative microscope, the tumors were totally removed in 10 cases, subtotally in 4 cases, and partially in 2 cases. Fllowed up from 5 months to 8 years, 11 cases recovered well, 4 cases suffered from moderate disability, and 1 case died. Preoperative CT or MRI scan, knowledge of the anatomy and structures, and skillful operative techinique all were important to microsurgical treatment of recurrent intra-spinal canal tumors. Conclusion Once diagnosis of recurrent intra-spinal canal tumors, the operative treatment is effective. Radiation therapy for the malignant tumors or incompletely removed recurrent tumors is necessary.

Chikungunya virus ; genetics ; isolation & purification ; China ; Genome, Viral ; RNA, Viral ; genetics ; Sequence Analysis, RNA

Objective To investigate the effect of seretide plus montelukast on clinical symptoms、pulmonary functions and the serum IL-6 and TNF-α of patients with asthma.Methods 73 cases patients with asthma were randomly divided into seretide group and seretide plus montelukast group and were treated respectively for two weeks.The clinical symptoms,lung functions and serum IL-6,TNF-α contents of patients were measured respectively before treatment and after two weeks treatment.Results After two weeks treatment,the clinical symptom scores、FEV1.0、FVC and PEFR of two groups had significantly changed than that before treatment(P<0.05);Each index was further compared after treatment,and it was found that two groups had significant differernces statistically (P<0.05),these showed that combination of seretide and montelukast could significantly enhance the therapeutic effect.After treatment,the TNF-α and IL-6 contents in the peripheral blood of seretide group and seretide plus montelukast group had both significantly reducted (P<0.05 or P<0.01);The TNF-α and IL-6 contents of seretide plus montelukast group had reduced more significantly than that of the seretide group(P<0.05).Conclusion The seretide plus montelukast group could improve the clinical symptoms and pulmonary function of patients with asthma,and the action mechanism might be related to lower the serum IL-6 and TNF-α contents.

Seven genes (fabD, fabG, fabH, fabA, fabZ, fabB and fabI) of E.coli fatty acid biosynthetic enzymes were cloned by PCR amplifying and appropriate expression vectors were constructed. Under induction assay expression of plasmid encoded proteins was carried out in strain BL21(DE3) and seven enzymes were purified using Ni-NTA agarose resin. In the absence of [2-14C] malonyl-CoA fatty acid synthetic reaction was reconstituted in vitro by adding seven enzymes and co-factors. And several model reactions were established for identification of special fatty acid biosynthetic enzymes. Meanwhile Clostridium acetobutylicium FabZ function was characterized by this method.

Objective To discuss the treatment strategy of medial collateral ligament and combined injury in the terrible triad of elbow.Methods The data of 21 patients with terrible triad of elbow who received treatment from February 2010 to April 2012 was retrospectively analyized.There are 17 males and 4females with12 cases left and 9 right elbows.The average age of them was 37.6 years (16-57).MRI examination was performed routinely,and used as guidance of treatment strategy of medial collateral ligament and combined injury.For the patients without or with partial damage of anterior bundle of medial collateral ligament(AMCL) injury while the continuity of ligament remains complete in MRI image,exploration and repair of the medial collateral ligament is not conventional.For the patients with MRI image showing AMCL avulsion or body disruption,we routinely used antero-medial approach to explore and repair,suture-anchors were used for suture the bony avulsion of the medial collateral ligament,body disruption of ligament and combined flexor-pronator teres complex injury were also be suture repaired.None of the patients used hinged external fixator during operation.A hinged brace was applied after operation.Results All patients were followed up for an average of 12.4 months (6-26).At the last follow-up,the average range of motion of the elbow was 135.2 ±10.2 degrees,average straight limited degrees,6.7±2.2 degrees,an average of 142±11.0 degrees of flexion.Mayo elbow performance score was 92 points (85-100).17 cases were excellent and 4 were good.Complications included:a transient ulnar nerve palsy in 3 cases,heterotopic ossification in 2 cases,tardive ulnar neuritis in 1 case,no elbow residual instability,dislocation,elbow stiffness and other complications.Conclusion Anterior bundle of medial collateral ligament avulsion or body disruption should be routinely suture repaired,which is in favor of restoring elbow immediate stability favoring restore elbow immediate stability.