ObjectiveTo investigate the efficacy of combined therapy of mild hypothermia and hibernation to treat severe brain injury. Methods24 patients with severe brain injury were randomly divided into combined therapy group and normothermia group. Glasgow Coma Scale scores of all the patients were in the range of 3 to 8. No later than 10 hours after their injury, hypothermia patients were given half dosage of No.1 hibernation cocktail and had been cooled by cooling blankets to 32℃-34℃ (rectal temperature) for 5 days, then to 35℃ for 24 hours, and slowly increased to their normal level. 3 days and 7 days after their admission, intracranial pressure,creatine phosphate kinase,partial pressure of arterial O2 and CO2, platelet and Na+,K+ were measured.7 days after their admission, Glasgow Outcome Scale scores of each patient and mortality of each group were measured. ResultsThe mortality of combined therapy group(25.0%) was significantly lower than that of normothermia group (66.6%,P<0.05). The decreased values of intracranial pressure, creatine phosphate kinase and platelet number of combined therapy group were all significantly higher than that of normothermia group respectively (P<0.05). There were no significant difference in mean artery pressure, blood electrolyte, and partial pressure of arterial O2 and CO2 between these two groups(P>0.05). ConclusionThe combined therapy of mild hypothermia and hibernation can effectively reduce the mortality of patients with severe brain injury as it is much easier, less invasive and with less complications.

OBJECTIVETo study the effective method of microsurgical resection of the recurrent craniopharyngiomas.

METHODSMicrosurgical resection underwent in 40 cases with the recurrent craniopharyngiomas that accounted for 24 men and 16 women with mean age 35.1 year old. Visual deterioration was mainly complained in 25 patents, headache of symptoms in 9 patients, defect of visual field in 2 patients, amenorrhea in 2 patients, hyposexuality in one patient and diabetes insipidus in the one. Average history was 2.9 years. The superior sellar tumors on MR imaging grew in 19 cases, the superior-inferior sellar mass in 9 cases, intra-sellar in 5 cases and the tumors into the third ventricle in 7 cases. The huge calcification tumors were found in 5 cases, cystic tumors in 21 cases, and solid tumors 2 cases. Hydrocephalus presented in 12 cases. Evolution of tumor residuum was revealed in 31 cases after initial surgery and recurrent tumor after completing total removal of the tumor in 9 cases. The pterional approach was employed in 33 cases. The longitudinal fissure to the corpus callus approach in 2 cases was available for resection of the third ventricular tumor through the fornix column and septum pellucidum spaces.

RESULTSIn 33 cases with the pterional approaches, total removal of the tumors were completed in 22 cases, subtotal removal of tumors in 9 cases, and partial removal in 2 cases. In 5 cases with subfrontal approach, 4 patients the total removal of tumors obtained in 4 cases and one subtotal removal of tumor in one. Of 2 cases with the longitudinal fissure to the corpus callus approaches, one case was achieved with the total removal of tumor and the other with subtotal removal of tumor. The pituitary stalk was preserved in 8 cases, the pituitary stalk was severed in 9 cases and the pituitary stalk was not identified in 23 cases when surgery. 17 patients experienced diabetes insipidus and 12 patients had the hypothalamic hypofunction after surgery. One death occurred from the hypothalamic hypofunction 35 day after surgery. By follow-up from 3 months to 3 years, 22 patients returned normal life, 11 patients can carry out their self-life, and 6 patients need care.

CONCLUSIONSThe desirable removal of recurrent craniopharyngioma could be completed in the majority of patients although the reoperation of the tumors was performed very difficulty owing to the tumor adhesive to the surrounding hypothalamic structures.

Adolescent ; Adult ; Child ; Craniopharyngioma ; surgery ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery ; Reoperation ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo examine the distributions of beta-catenin and adenomatous polyposis coli (APC) protein in the tooth germ, and obtain the messages of function of the two factors and the relationship between them.

METHODSMice were selected and cohabited with the ratio of female mice to male ones being 2:1, and Embryo day 0.5 was confirmed based on the finding of vaginal plug. The distributions of beta-catenin and APC protein in the Embryos on day 13.5, 14.5, 15.5, 16.5, 17.5 were examined in the paraffin-embedded sections by immunohistochemistry methods.

RESULTSDuring E13.5 d to E17.5 d, positive expression of beta-catenin was found in the oral epithelium and the dental lamina, and became more and more strong. The staining were whole cell. During the bud stage, strong positive expression of APC protein was found in the oral epithelium and the dental lamina, but the expression displayed a down-regulation tendency. The staining was the cytomembrane and cytoplasm. There was negative correlation between beta-catenin and APC protein (P<0.01).

CONCLUSIONThe result of beta-catenin suggests its contribution in the early development of enamel organ and the proliferation of cell. Coincidance of the two factors staining site was found, according to the statistics.

Adenomatous Polyposis Coli Protein ; Animals ; Cytoskeletal Proteins ; Female ; Immunohistochemistry ; Male ; Mice ; Tooth Germ ; beta Catenin

ObjectiveTo investigate the current status of Kaschin-Beck disease in Shandong province, and to provide a scientific basis for decision-making in controlling the disease. Methods According to the National Monitoring Program of Kaschin-Beck disease requirements, historical serious villages of Kaschin-Beck disease in Qingzhou of Shandong province were selected annually; children aged 7 to 16 were chosen to receive clinical examination and children aged 7 to 12 were taken X-ray examination. Clinical and X-ray diagnosis was carried out according to the Diagnostic Criteria of Kashin Beck Disease(GB 16003-1995). Results From 1996 to 2010, in 53 diseased villages, three thousand three hundred and eighteen school children aged 7 to 16 were clinically diagnosed, and child Kaschin-Beck disease of degree Ⅰ and above were not detected; three thousand and ninety-one school children aged 7 to 12 were examined by X-ray, forty cases were found positive, and the total positive rate was 1.29％(40/3091 ). The year with the highest positive rate was 2002, and the rate was 3.49％(13/372) ; the positive rate was 0 in 1996 and 2008. The difference of the X-ray positive rate between each year was statistically significant(x2 =31.54, P ＜ 0.01 ). ConclusionsChild Kashin-Beck disease in Qingzhou is basically under control.Since etiology of Kashin-Beck disease is still unclear, surveillance of the disease still needs to be strengthened.

Objective To evaluate the changes in the mental health status of the Wenchuan earthquake survivors in relation to their transfer to other provinces. Methods Sixty-eight survivors of the Wenchuan earthquake were evaluated for the mental health status using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and after transfer to other provinces. Results The score of SAS of these survivors decreased significantly after the transfer (42.78±7.95 before transfer vs 38.15±7.55 after transfer, P<0.05), and the SDS score also decreased significantly (45.40±9.30 vs 40.84±9.20, P<0.05). The transfer was associated with a significant reduction in both the SAS and SDS scores of the survivors irrespective of the injuries sustained in the earthquake. After the transfer, the survivors without injuries showed significantly lower SAS scores than those sustaining injuries in the earthquake (P<0.05), but the SDS scores either before or after the transfer have no statistical significance between the 2 groups (P>0.05). Conclusion Transfer to other provinces may help relieve the anxiety and depression in both the injured and non-injured survivors in a short period for the benefit of their psychological rehabilitation.

Objective To observe distribution and antimicrobial resistance of pathogens from blood culture of chil-dren with leukemia,and study risk factors.Methods From September 2013 to November 2016,species and antimi-crobial resistance types of 131 strains of pathogens isolated from blood culture of 110 children in a pediatric hemato-logy ward were analyzed,childrens'clinical data were also analyzed statistically.Results 131 strains(5.23%)of pathogens were isolated from 2 505 blood culture specimens,gram-negative bacilli and gram-positive cocci accounted for 52.67% and 43.51% respectively,the top 3 pathogens were Escherichia coli(15.27%),Klebsiella pneumoniae (15.27%),and Staphylococcus hominis(12.98%). Gram-negative bacilli were highly resistant to ampicillin,ce-fazolin,ceftriaxone,and ampicillin/sulbactam,but sensitive to amikacin,cefoperazone/sulbactam,piperacillin/tazobactam,and carbapenems;gram-positive cocci had higher resistance to penicillin,oxacillin,erythromycin,and clindamycin,but were sensitive to tigecycline,linezolid,vancomycin,and quinupristin/dalfopristin. Univariate analysis showed that mixed infection,diarrhea,Pseudomonasaeruginosa infection,and Acinetobacterbaumannii in-fection were related to mortality due to bloodstream infection in children with leukemia.Conclusion Pathogens cau-sing bloodstream infection in children with leukemia is widely distributed,antimicrobial resistance rate is high,it is very im-portant to take active precaution and rational treatment according to antimicrobial susceptibility testing result.

Objective To understand the situation of client-retention to methadone maintenance treatment(MMT)program and related factors.Methods A Cohon study was adopted.In toml,1003 heroin addicts who were treated at 8 local MMT clinics with less than one month period.were recruited under nominal informed consent from Guizhou province.southwest part of China.during June to October 2006.Face-to-face interview and questionnaire administered to collect relevant information from the clients who were also followed nntil June 2007 to understand the situation on retention.Data were analyzed with Kaplan-Meier method to estimate the retention rate at different time spans while factors related to retention were analyzed with Cox proportional hazard regression model.Results All the clients were followed-up for 14 months,with an average retention of ten months.The retention rates of the clients were 68.8%and 57.4%at 6th-month and 12th-month of the treatment program.estimated by Kaplan-Meier method.Results of Cox regression analysis showed that factors influencing retention rate on MMT among the clients,including their awareness on MMT,dailv dose of methadone intake,and difierent MMT clinics which they were attached to.Risk influencing the withdrawal from MMT had a 20%decrease along with the increase when the daily dose of methadone intake reached 25 mg,with a hazard ratio of 0.80(P＜0.01).If the clients were aware that methadone was a life-time treatment when they began the MMT program.the risk for withdrawal would be lower than those who were not and the hazard ratio became 0.66(P＜0.05).Conclusion Our data showed that about half of the clients who were at the MMT program would still stick to it after 12-months.suggesting that the retention rate was not satisfactory and need to be improved.Factors as the MMT clinics themselves that the clients visited,(Laily methadone dosage they took,and the awareness on MMT etc.were important predictors to the rate of retention on MMT program.

Objective To explore the effect of polyethylene glycol-polyethyleneimine (PEG-PEI) serving as a non-viral vector in delivering small interfering RNA (siRNA) into C17.2 neural stem cells (NSCs) in vitro. Methods Complexes of PEG-PEI and siRNA targeting Nogo receptor were prepared, and their characterizations were estimated by measurements of particle size and zeta potential,and the complex abilities of PEG-PEI/siRNA complexes were observed by gel retardation assay. In addition, with liposome complex system (Lipofectamine 2000/siRNA) as positive control, the transfection efficiency of PEI-PEG/siRNA complexes at different N/P ratios (cationic nitrogen/siRNA phosphate molar ratio) was detected by flow cytometry. Results The siRNA molecules were condensed by PEG-PEI to form nanoseale complexes. As the proportion of N/P ratio enhancing, the surface potential of nanoparticles gradually increased and the particle sizes of PEI-PEG/siRNA complexes showed a decreasing trend. Gel retardation electrophoresis suggested that siRNA could be fully composited with PEG-PEI as a result of the coulombic foree between them. Meanwhile, flow cytometry experiments revealed that the transfection efficiency of PEG-PEI mainly depended on N/P ratios of the nanoparticles,and the highest one was obtained at N/P=15 ([78.72±8.18)]％). Conclusion PEG-PEI might be a prospective candidate for siRNA delivery system, which enjoys its value in NSC gene therapy.

OBJECTIVETo investigate the clinical heterogeneity of movement disorder in Parkinson's disease (PD).

METHODSNinety-eight PD patients (68 males and 30 females) were divided into tremor-dominant PD (n=23), mixed subtype PD (n=29) and postural instability and gait disorder (PIGD)-dominant PD (n=46) groups, and the clinical heterogeneity of the movement function of the patients was compared.

RESULTSThe initial symptom of tremor-predominant PD was tremor, but patients with PIGD-dominant PD had rigidity and gait disorder as the initial symptoms, commonly compromising the left limb. The amended Hoehn-Yahr stage of tremor-dominant PD was significantly lower than that of the PIGD-dominant PD, while the score of Mini-Mental State Examination (MMSE) was significantly higher in the former. No statistical differences were found in the gender, course of disease and family history between the patients with different subtypes of PD.

CONCLUSIONThere are significant differences in the initial and typical symptoms between tremor-dominant PD and PIGD-dominant PD.

Aged ; Female ; Gait Disorders, Neurologic ; classification ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Movement Disorders ; classification ; pathology ; physiopathology ; Parkinson Disease ; classification ; pathology ; physiopathology ; Postural Balance ; Tremor ; pathology ; physiopathology

OBJECTIVETo investigate the staphylococcal cassette chromosome mec (SCCmec) genotype and molecular epidemiological characteristics of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) in a large teaching hospital in China.

METHDOSFrom January 2012 to December 2012, a total of 71 nonduplicate HA-MRSA were collected in a teaching hospital in Changsha, China. SCCmec types were determined by multiplex PCR, and Panton-Valentine leukocidin (PVL) gene was detected by PCR. The homology among the tested isolates was determined using pulsed-field gel electrophoresis (PFGE).

RESULTSOf the 71 HA-MRSA isolates, 49 (69.0%) carried SCCmec III, 10 (14.1%) carried SCCmec IV, 3 (4.2%) carried SCCmec V and 3 (4.2%) carried SCCmec II; the remaining 6 isolates were not typeable by PCR. Compared with patients having SCCmec I/II/III MRSA infections, those with SCCmec IV/V MRSA infections had a significantly younger age and a similar duration of hospital stay before the first MRSA-positive culture and total hospital stay. PVL genes were strongly associated with SCCmec type IV/V MRSA infections. HA-SCCmec IV/V MRSA strains showed a greater susceptibility to rifampicin, gentamicin, levofloxacin, ciprofloxacin, and tetracycline than HA-SCCmec I/II/III MRSA strains. The 13 HA-SCCmec IV/V MRSA isolates formed one large group at the 55% similarity level. Three PFGE clusters with a similarity index of 85% or more were identified, and unique PFGE profiles were observed in 4 isolates.

CONCLUSIONThis is the first report of HA-MRSA isolates carrying SCCmec V in Chinese hospitals. SCCmec types IV and V MRSA clones have emerged in Chinese hospitals, which urges more rigorous surveillance of their spread in healthcare facilities in China.