Catecholamines ; blood ; cerebrospinal fluid ; metabolism ; Child ; Humans ; Neuropeptides ; blood ; cerebrospinal fluid ; metabolism ; Neurotransmitter Agents ; blood ; cerebrospinal fluid ; metabolism ; Syncope, Vasovagal ; blood ; cerebrospinal fluid ; metabolism ; physiopathology

Objective To investigate the clinical efficacy of the self-retaining laryngeal microsurgical operation in the treatment of Reinke ’ s edema of vocal cords . Methods There were 24 cases of Reinke ’ s edema who were treated with self-retaining laryngoscope mucosal stripping surgery of vocal cords from January 2004 to December 2009 ( traditional group ) , while another group of 32 cases of Reinke ’ s edema were treated with self-retaining laryngoscopic microsurgery lateral submucosal incision micro-flap operation of vocal cords from January 2010 to December 2015 ( laryngeal microsurgery group ) .The two groups were executed with electronic laryngoscopy and subjective voice evaluation GRBAS ( The Speech and Language Institute of Japanese in 1979, G: Grade, R:Roughness, B:Breathness, A:Asthenia, S:Strain) in pre-operation and post-operation (1 week, 3 weeks, 8 weeks).The wound healing time of vocal cords , hoarseness improved time and voice improvement were retrospectively compared between the two groups . Results The patients in laryngeal microsurgery group had earlier voice hoarse improvement and more rapid mucosal epithelial of vocal cords recovery time in post-operation as compared with the patients in the traditional group [voice improving time, (7.3 ±1.9) d vs. (11.3 ±2.7) d, t=-6.481, P=0.000;mucosal epithelial of vocal cords recovery time , (12.2 ±3.1) d vs.(20.1 ±3.4) d, t=-9.062, P=0.000].The results of pre-operative voice evaluation with GRBAS showed no significant differences between the two groups, but the results of post-operative evaluation of each session (1 week, 3 weeks, 8 weeks) showed that the main data were statistically different.The GRBAS score of laryngeal microsurgery group was lower than that of traditional group in post -operation, especially after 8 weeks (8 weeks after post-operation, G:1.0 ±0.8 vs.1.6 ±0.2, t=-3.584, P=0.000; R:1.0 ±0.9 vs. 1.5 ±0.4, t=-2.536, P=0.014;B:1.0 ±0.6 vs.1.4 ±0.5, t=-2.647, P=0.011).In laryngeal microsurgery group, 24 cases were cured , 5 cases were effective and 3 cases were invalid , contrasting in the traditional group with 11 cases of cured , 7 cases of effective and 6 cases of invalid respectively, with a significant difference (Z=-2.239, P=0.025).No significant difference in effective rate between the two groups [90.6%(29/32) vs.75.0%(18/24),χ2 =1.459, P=0.227]. Conclusion The clinical efficacy of self-retaining laryngoscope microsurgery in the treatment of Reinke ’ s edema of vocal cords is faster and better comparing traditional operation , with a more significant pronunciation quality improvement .

Lumbar intervertebral disc herniation clinical symptoms and signs are very complicated, lumbocrural pain is the most characteristic clinical symptoms,and show the site (range or area), intensity, nature, evolution, influence factors and adjoint symptoms and so on has certain characteristics and rules. Among them, the dermatomal pain, kinesthetic dysesthesia, dynamic changing pain and lesions segment vertebral side deep tenderness are the most impotent characteristics and rules of pain, therefore, can be regarded as the main basis of clinical diagnosis of the disease, and also the core content of this article.
Back Pain ; diagnosis ; etiology ; pathology ; Humans ; Intervertebral Disc Displacement ; diagnosis ; pathology ; Lumbar Vertebrae ; injuries ; pathology

Pain is all lumbocrural pain cases very common clinical symptoms,but the etiology, pathology, site (range or area), intensity, nature, evolution situation and influence factors of pain usually has some certain characteristics and rules, these differences particularly are regarded as the primary and important basis or clue for the clinical diagnosis and differential diagnosis of related diseases. In addition, according to these differences can determine the individual diagnosis of lumbar intervertebral disc herniation as well, including typical and atypical, simple and compound, the general and special cases, these be- come the basis to determine the individualized therapeutic schedule of this disese.
Back Pain ; diagnosis ; Humans ; Intervertebral Disc Displacement ; diagnosis

Pain is common clinical symptoms of lumbocrural, but the etiology, pathology, sites (range or area), intensity, nature, evolution situation and influence factors of pain has some certain characteristics and rules. These differences particularly were regarded as the primary and important basis or clues for the clinical diagnosis and differential diagnosis of related diseases. A series of exclusive diagnosis for similar symptoms is premise of diagnosis of lumbar intervertebral disc protrusion. Ideas and methods of differential diagnosis of lumbar intervertebral disc herniation can help the diagnosis and identification.
Diagnosis, Differential ; Humans ; Intervertebral Disc Displacement ; diagnosis ; Lumbar Vertebrae

BACKGROUND:Titanium implants as a safe biological material have been used to produce the artificial Russian titanium cornea, but complications stil exist, including artificial cornea shift, leakage, corneal tissue melting and artificial cornea discharge.
OBJECTIVE:To evaluate in vivo biocompatibility of hydroxyapatite modified titanium skirt for keratoprosthesis in alkali burn cornea.
METHODS:A total of 30 alkali burned New Zealand white rabbit corneas were divided into three group groups. Hydroxyapatite modified titanium skirt (experimental group) and titanium skirt (control group) were respectively inserted into the corneal stroma of rabbits. In the blank control group, only a lamel ar corneal incision was made.
RESULTS AND CONCLUSION:Al skirts were stable without necrosis, melting and exclusion during the observation period. The number of inflammatory cells in the experimental and control groups was significantly higher than that in the blank control group at 2 and 8 weeks postoperatively (P<0.05), but there was no difference in inflammatory cellinfiltration among different groups by the 16th week. The number of corneal fibroblasts increased significantly in the experimental group compared with the control and blank control group after 2, 8, 16 weeks (P<0.05). The extracellular matrix deposited on the surface of hydroxyapatite modified titanium skirt was denser and tighter than that on the surface of titanium skirt. It indicates that hydroxyapatite modified titanium skirt for keratoprosthesis can promote the interfacial biointegration of skirt and host cornea.

Objective To study the application value of electroencephalogram and CT in children with cerebral palsy.Methods Electroencephalogram and CT examinations were carried out in 224 children with cerebral palsy.Results Abnormal prevalence of electroencephalogram was 47.77%, 58.88% of which were found as epileptic discharge. Abnormal prevalence of CT was 79.46%. The abnormal rate of CT was significantly higher than that of electroencephalogram ( P<0.001). The abnormal rates of electroencephalogram and CT among different types of cerebral palsy were not significantly different ( P>0.05).Conclusion Combination of CT and electroencephalogram will be helpful for the diagnosis and treatment in children with cerebral palsy.

Tolvaptan is a novel oral selective arginine vasopressin V2 receptor antagonist.Tolvaptan improves heart failure signs and symptoms without serious adverse events.Tolvaptan has no effect on all-cause mortality and cardiovascular death or admission rate for heart failure.But in heart failure patients with hyponatremia,tolvaptan can decrease cardiovascular death and admission rate for heart failure.

Objective To analyze the activities of daily living (ADL) performance in children with cerebral palsy (CP) with different gross motor function and the correlation between gross motor function and ADL perform-ance. Methods A total of 118 children (81 boys and 37 girls; mean age: 47.7 months, SD: 20.1 months, age range: 18-90 months) with CP were recruited from three different rehabilitation centers in Shanghai. Types of CP included hemiplegia (n = 27), spastic diplegia (n = 53), spastic quadriplegia(n = 29), athetoid (n = 4), dystonic (n = 4), ataxic (n = 1). Gross motor function classification system (GMFCS) and Gross motor function measure (GMFM) were adopted to assess and classify the gross motor function. Pediatric evaluation of disability inventory (PEDI) was adopted to assess ADL performance. Differences of PEDI scores were compared among different levels of GMFCS; and the correlation between GMFCS levels, GMFM scores and PEDI scores were analyzed. Resnlts PEDI scores showed significant differences among CP children with different levels of GMFCS. The PEDI score usually de-creased with the increase of the GMFCS level, and mobility ability was the lowest. Significant correlations were found between PEDI scaled scores and GMFCS (rs = 0.85～0. 50, P < 0.001). Various levels of correlations (r = 0. 85～ 0.54, P<0.001) were found between GMFM scores and PEDI scaled scores. Higher correlations were found between GMFCS levels, GMFM scores and mobility ability. Conclusion ADL performance was significantly different among CP children with different gross motor function. The higher the gross motor function, the better the performance of ADL. Mobility would be improved by promoting gross motor function in CP children. The training of self-care and so-cial communication ability should be emphasized.

ObjectiveTo investigate the effect of Smad7 antisense oligodeoxynucleotide (ASODN) on proliferation in human pancreatic cancer cell line SW1990,with a focus on the expression of matrix metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2).To explore the underlying mechanism of the role of Smad7 in the pathogenesis and development of pancreatic cancer.MethodsSmad7 ASODN was transfected into SW1990 cells through lipofectamine.Nosense oligodeoxynucleotide (NSODN),ASODN and lipofectamine was used as control. The transfection efficiency was assessed by fluorescence microscopy and flow cytometry.The expressions of Smad7,MMP-2 and TIMP-2 in transfected cells were detectedby RT-PCR and Western blot.Cell viability was assessed by dimethyl thiazoldiphenyltetrazoliumbromide (MTT) method. Results Smad7 was expressed in SW1990 cells.The transfection efficiency of SW1990 was 81.2％.The expressions of Smad7 mRNA were 0.34 ± 0.06,0.95 ±0.07,1.03 ± 0.11 in transfected group,ASODN and lipofectamine group; and the expressions of MMP-2 mRNAwere 0.54 ± 0.08,1.15 ± 0.13,1.27 ± 0.16 ; and the expressions of TIMP - 2 mRNA were 0.26 ±0.07,0.72 ± 0.13,0.78 ± 0.17,the mRNA expressions were significantly reduced in Smad7 ASODN transfected group,compared with other two groups (P ＜0.01 ).The expressions of Smad7 protein were 0.14 ± 0.03,0.29 ± 0.05,0.28 ± 0.07 in transfected group,ASODN and lipofectamine group; the expressions of MMP-2 protein were 0.17 ±0.02,0.29 ±0.05,0.31 ±0.04,and the expressions of TIMP-2 protein were 0.20 ± 0.03,0.41 ± 0.11,0.43 ± 0.09,the protein expressions were significantly reduced in Smad7 ASODN transfected group,compared with other two groups (P ＜0.01 ).The A490 values of proliferation were 0.83 ± 0.03,1.02 ±0.02,0.99 ±0.02 in transfected group,ASODN and lipofectamine group,the proliferation were significantly reduced in Smad7 ASODN transfected group,compared with other two groups (P ＜0.01 ).ConclusionsSmad7 ASODN could effectively inhibit the expressions of Smad7,therefore decrease the expressions of MMP-2,TIMP-2 and reduce the proliferation.