Objective To investigate and understand the reference value range of hematological parameters for peripheral blood routine in preschool children from Shanghai.Methods The Sysmex XS-800i automated hematology analyzer and the original rea-gents were used to measure the hematological parameters in peripheral blood samples collected from 7 692 healthy preschool chil-dren aged 2-6 years in Shanghai,including white blood cells(WBC),red blood cells(RBC),platelet(PLT)count,hemoglobin(Hb), hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH)and mean corpuscular hemoglobin con-centration(MCHC);the various parameters in different age groups were collected and statistically processed to establish the refer-ence intervals for each parameter.Results In the blood routine among preschool children in Shanghai,there were statistically signif-icant differences in all parameters except WBC and PLT count between sexes among preschool children in Shanghai(P <0.05).The reference intervals of hematological parameters obtained in this investigation were obviously differed from those offered by the man-ufacturer.However,compared with those from the related reports,the difference existed in partial parameters,the upper limit of WBC count was highest compared with the results from some areas,while the reference value ranges of MCV,MCH and MCHC were higher than those of other area study results.Conclusion The independent blood routine medical reference value range for preschool children in Shanghai should be established and the influence of the factors of gender,instrument and reagents also should be taken into consideration in establishing the reference value range.

[Objective]To discuss the effective treatment of complicate intertrochanteric hip fracture.[Method]Thirty-five cases with complicate intertrochanteric hip fracture.The class of fracture,surgery method,operating time,complicatico,union rate of fracture were amounted statisti cally.[Result]All the 35 cases were surgical treated,l 4 cases with PFN(priemeral femur nail),21 cases with DHS(dynamic hip screw)with mean time of operation 1.8 h(1.5~3 h),mean amount of blood loss during operation 300 ml(150~500 ml),mean time in bed 2.4 monthes (1.2~3 monthes),mean following-up time 12 months(6~16months).Thirty-one cases got union,3 cases union time delayed,1 case nounion,union rate was 88.5%.Four cases suffered hip iversion( 11.4%),the screw in the neck removed in 6 cases(8.5%),5 cases feeled pain in hip( 14.2% ).[Conclusion]The complicate intertrochateric hip fracture is a kind of fracture which can not be treated easily.Using PFN and DHS can not control the stability effectively.Additional fixation of the greater trochantar fracture is necessary.Added out-fixation and avoid early bearing are useful.

[Objective]To evaluate the effect of nonoperative and operative treatment in calcaneal fractures.[Method]Operative effect of 38 cases of calcaneal fracture of all kinds(42 foots)were analyzed.Accordind Essex-Loprestis classification,6 foots suffered type I tongue fracture,28 foots suffered compressed fracture(type Ⅱ),8 foots suffered serious comminuted fracture(type Ⅲ).All patients underwent open reduction interal fixation by Buttress plate(AO calcaneal fracture plate or simulated AO calcaneal fracture plate made domestically) from the extended "L" lateral approach.Postoperatively,no patient needed plaster fixation.All patients started non-weight-bearing fuctional exercise at 2-3days,gradual weight-bearing walking at 6-8 weeks.The result of operated group was compared with nonoperative treatment group.The follow-up period was from 10 months to 36 months,with an average of 17monthes.[Result]Assessed the effect by Maryland foot score,the base line included every foot.Total excellent and good rate in operative group was 93%,it was 100% in type I fracture group,96% in type Ⅱ fracture group,75% in type Ⅲ fracture group.The result of nonoperative treatment group was:total excellent and good rate was 67%,it was 92% in type I fracture group,77% in type Ⅱ fracture group,there was not excellent and good patients in type Ⅲ fracture group.[Conclusion]It is important to regain the flatness of subtalar joint and calcaneocuboid joint,maintain the normal shape of foot.The authors recommend that type Ⅱ and type Ⅲ fractures of calcaneus according Essex-Loprestis classification were treated with open reduction and interal fixation by Buttress plate.By selecting the appropriate approach,proper reducting and postoperative treating rightly,it is an ideal measure to treat calcaneal fracture by selection of treatment method acciding to patient's individual status and fracture type.

[Objective] To investigate the clinical significance of changes in serum biochemical factors in trauma patients,and to improve the initial determination of the injury degree and rescue ratio.[Method]From April 2002 to December 2004,48 trauma patients were divided into two groups of serious and slight injury by ISS score.The author monitored the concentration of serum GLU,CR,BUN,LDH,CK,CKMB,LDL,GPT,GOT,IgG,IfA,IgM,C3,C4,CRP and the WBC,PLT,BT(body temperature)at the first day and after 3,7,14 days,recorded the therapy method and results.The difference between the two groups was compared by statistic method.[Result]In 48 patients,There were 12 in slight injury group,36 in serious injury group.The concentration of GLU,LDH,CK,CKMB,CRP in serious group was more than that in slight group,but the concentration of LDL,IgG,IgA,IgM,C3,C4 was lower(P0.05).There were 6 patients suffered MODS,2 cases suffered ARDS,3 patients suffered upper digestive tract bleeding,2 cases combined with infection,1 case suffered DIC,and I death in serious group;there was 1 MODS,1 infection and no death in slight group.[Conclusion]The combined use of the AIS-ISS90 score and serum biochemical factors is advantageous to the determination of injury degree and prognosis.

As the major commercial source of natural rubber,Hevea brasiliensis attracts much attention.However,the heterozygous nature,long breeding cycle are strong limitations for conventional breeding.While genetic engineering,which can be used to widen the germplasm base and produce desirable agronomic traits quickly and efficiently,offers a viable alternative approach to complement traditional breeding.Comprehensive analysis indicates that in the past two decades,with calli derived from immature anther or integumental tissues of immature fruit as receptors,both biolistic and Agrobacterium-mediated transformation methods were employed for developping rubber genotypes with improved latex yield,tolerance to tapping panel dryness syndrome,producing high-value recombinant proteins,etc.Being recalcitrant to tissue culture,the transformation efficiency of Hevea is comparatively low,and the procedures are still needed to optimize.Finally,breeding objectives and strategies to improve transformation efficiency were also proposed in the review.

Objective To assess the coronary flow reserve in the patients with systemic lupus erythematosus(SLE)by transthroracic echocardiography(TTE).Methods Coronary sinus blood flow of 24 SLE patients and 18 matched healthy controls were assessed by TTE.The coronary flow reserve was calculated as the ratio of hyperemic to baseline blood flow.Hyperemia was induced by intravenous administration of dipyridamole.Results Adequate recordings of blood flow in the coronary sinus under both conditions were obtained by TTE in all study subjects.Patients with SLE were found to have significantly decreased coronary flow reserve comparing with normal SUbiects(1.55±0.21 versus 2.51±0.33.P＜0.01).Conclusions Coronary flow reserve can be measured by TTE in SLE patients,Coronary flow reserve is impaired suggesting that SLE patients may have subclinical coronary artery disease.

BACKGROUND: Transplantation of microencapsulated rabbit Schwann cells in the rat spinal cord can relieve inflammatory reaction, promote spinal cord regeneration, but the precise mechanisms remain unclear. OBJECTIVE:To observe basic fibroblast growth factor (bFGF)expression and movements recovery following transplantation of microencapsulated rabbit Schwann cells in rat spinal cord. METHODS: The sciatic nerves taken out from rabbits wore digested with mixed enzyme and were made into Schwann cells suspension. Then we used air-jet method to make Schwann cells microcapsule. Using the same method, empty microcapsule was made. Sprague Dawiey rats were randomly divided into cell group, empty microcapsule group and microcapsule group. Conducted by hemisection injury of spinal cord,the rats in cell group,empty microcapsule group and microcapsule group were implanted with gelatin sponge with 10μL Schwann cells suspension, gelatin sponge with 10 μL empty microcapsule and 10 μL microencapsulated Schwann cells. Normal group was left intact. After operation, we observed hindlimb movements recovery in rats with the Basso, Beattie, and Bresnahan (BBB) scale. Meanwhile,a set of sections were stained immunohistochemically for bFGF expression, another set of sections wore stained for hematoxylin-eosin and Nissal. RESULTS AND CONCLUSION: After spinal cord injury, rat right hindlimb affected paralysis immediately. At 7, 14 and 28 daysfollowing transplantation,motor function in rat hindlimb was significantly recovered, and the BBB scores were significantly higher in microencapsulated schwenn cells than in cell and empty microcapsule group (P < 0.05 or P < 0.01). bFGF positive products were mainly distributed in cytoplasm of the spinal neuron and nucleus of neuroglical cell. The numbers of bFGF positive glial cells mainly appeared surrounding the spinal cord injured site on days 1, 3, 7 and rose to its peak on day 3 and began to appear in neuronal calls on day 14. The number of bFGF positiv cells in microcapsule group was significantly superior to that in cell group and empty microcapsule group. From then on, the bFGF expreSsion was significantly decreased in each group. These indicated that transplantation of microencapsulated Schwann cells can inhibit the immunological rejection after xenotransplantation, suppress inflammatory reaction, improve the expression of bFGF, increase hindlimb movements recovery and spinal cord regeneration after spinal cord injury.

Objective To investigate whether clinical,endocrine,and sonographic characteristics of infertile women with polycystic ovary syndrome (PCOS) could predict the ovarian response to clomiphene citrate (CC) medication.Methods A prospective study was conducted,85 women with PCOS were given CC 50 mg per day for 5 days.In the case of an absent response,doses were increased to 100 daily in subsequent cycles.Clinical,endocrine,and sonographic characteristics were compared between responders and nonresponders.Results The cycle history (oligomenorrhea or amenorrhea) and antral follicle count (AFC) were significantly different in responders from those in nonresponders (P ＜ 0.05).There were no differences in age,serum testosterone,follicle stimulating hormone (FSH),luteotropic hormone (LH),body mass index (BMI),insulin resistant index (HOMA-IR),and glucose and insulin levels between the two groups (P ＞ 0.05).In addition,multivariate logistic regression analysis indicated that cycle history and AFC were the predictors of ovarian response to CC treatment.Conclusions The cycle history and AFC can be used as the simple and effective parameters to predict ovarian response to CC treatment in PCOS patients.

Objective Evaluation of left ventricular ( LV) function has great clinical significance in patients with early chro-nic kidney disease (CKD).The study was to evaluate whether two-dimensional speckle tracking imaging (2D-STI) technique can offer additional information of cardiac dysfunction in early CKD patients . Methods Conventional echocardiography and 2D-STI echocar-diography were performed in CKD group of 20 patients at stage Ⅱ-Ⅲ and control group of 20 healthy volunteers .LV structure and function were evaluated by conventional echocardiography .Multidirectional strain , strain rate and LV twist parameters were analyzed by 2D-STI technique. Results There was no statistical difference in conventional echocardiographic parameters such as left atrial diam -eter, end-diastolic LV diameter and ejection fraction between CKD group and control group .By applying 2D-STI technique, CKD group had significantly decreased value of global longitudinal strain (-19.8 ±2.4)%and strain rate(-1.1 ±0.3)S-1 in comparison to control group(-22.6 ±2.1)%、( -1.8 ±0.2)S-1, along with significant increase in the values of maximum LV rotation (11.6 ± 4.4)°and LV twist(19.6 ±3.8)°in comparison to control group(8.2 ±3.7)°、(13.5 ±3.6)°(P<0.05).There was no differences in both global circumferential and radial deformation parameters as well as maximum rotation value of LV assist device between two groups(P>0.05). Conclusion 2D-STI can detect subclinical LV dysfunction sensitively in early CKD patients .

Objective: To explore the potential influencing factors of the quality guidelines for medical treatment by factor analysis.Method: We analyzed with the SPSS package 9 quality guidelines for medical treatment in the department of integrated TCM and Western medicine of a hospital,including the out-patient person-time,the number of discharges,the average days of hospitalization,the rate of bed utilization,the frequency of bed rotation,the rate of cure and improvement,the case fatality rate,the coincidence rate of diagnoses at admission and discharge,and the success rate of emergency treatment.Results: Four common factors were extracted,namely,the quantifiable factor,determined by the out-patient person-time,the number of discharges,the average days of hospitalization and the frequency of bed rotation;the treatment factor,determined by the cure and improvement rate and case fatality rate;the diagnostic factor,determined mainly by the rate of bed utilization and the coincidence rate of diagnoses at admission and discharge;and the emergency treatment factor,determined by the success rate of emergency treatment.The cumulative contribution rate of the 4 factors was 85.1%.Conclusion: The amount of medical work,the techniques of treatment,the ability of diagnosis and the efficiency of emergency rescue are the main influencing factors of quality guidelines for medical treatment.