Objective To determine an early and noninvasive predictor of chronic kidney diseaase(CKD),by detecting the correlation between the urinary Col-Ⅳ concentration,the renal tissue and renal lesions in patients with CKD Col-Ⅳ expression.Methods 98 CKD patients proved by renal biopsy were selected and 76 healthy people were enrolled as control.Urinary and serum Col-Ⅳ concentration were examined by enzyme-linked immunosorbent assay(ELISA).Renal Col-Ⅳ expression was detected by immunohistochemistry.Renal injury grade was semiquantitative by CMIAS image analysis system.The association between urinary Col-Ⅳ level and renal Col-Ⅳexpression,as well as renal lesion was analyzed,meanwhile the proteinuria and glomerular filtration rate(GFR)were analysed simultaneously.Results Urinary Col-Ⅳ level in patients with CKD was significantly higher than that in control,however,there was no difference in blood Col-Ⅳ level.Expression of Col-Ⅳ could be found in the sclerosing glomeruli and tubulointerstitial tissue,and Col-Ⅳ expression degree was consistent with lesion degree.Urinary Col-Ⅳ level was correlated positively with renal Col-Ⅳ expression,as well as with density of glomerular basement membrane and interstitial damage.Elevated urinary Col-Ⅳ concentration was observed in patients with mild renal sclerosis prior to the change of GFR.No correlation between urinary Col-Ⅳ concentration and proteinuria was observed.Conclusions These results suggested urinary Col-Ⅳ concentration reflected renal Col-Ⅳ expression and renal sclerosis,and could predict the progression of CKD.

Objective To evaluate the clinical outcome of the technique of step-by-step in situ rod bending used in posterior internal fixation of lumbar burst fractures.Methods A retrospective case control analysis was conducted on 76 cases of lumbar burst fractures hospitalized between March 2007 and March 2014.There were 48 males and 28 females,with a mean age of 40.4 years (range,18-57 years).Fractured segments included L1 in 32 cases,L2 in 24,L3 in 14 and L4 in 6.According to the different rod bending methods,the subjects were divided into preliminary rod bending group (34 cases) and in suit rod bending group (42 cases).Operation time,amount of bleeding during and after operation,restoration of anterior vertebral height and Cobb angle,and visual analogue score (VAS) were compared between groups.Results Seventy patients were followed up for 12-36 months (mean,20.9 months).One patient in preliminary rod bending group presented internal fixation loosening,and had implant removal 9 months after operation.No implant breakage occurred.Comparison of preliminary rod bending group and in situ rod bending group showed significant differences in operation time [(88.1 ± 16.0)min vs.(79.9 ± 14.7)min],amount of bleeding during operation [(88.3 ± 21.2) ml vs.(74.0 ± 12.5) ml],amount of bleeding after operation [(71.5 ± 17.3)ml vs.(62.1 ± 16.0) ml],restoration of anterior vertebral height [(74.1 ±7.8) ％ vs.(79.5 ± 8.5) ％],and restoration of Cobb angle [(10.2 ± 2.7) °vs.(8.8 ± 2.6) °] (P ＜0.01 or 0.05).VAS presented no significant differences between preliminary rod bending group and in situ rod bending group before operation [(7.5 ± 0.9) points vs.(7.2 ± 1.0)points] and 1 week after operation [(2.9 ± 0.7) points vs.(3.0 ± 0.7) points] (P ＞ 0.05),while there was significant difference 9 months after operation [2.2±0.7)points vs.(1.9 ±0.7)points] (P＜0.01).Conclusion In suit rod bending for lumbar burst fractures has advantages over preliminary rod bending in terms of operation time,blood loss,precise restoration and back pain.

OBJECTIVETo compare clinical outcomes of bilateral transpedicular balloon kyphoplasty for the treatment of ordinary osteoporotic vertebral compressive fracture (OVCF) and severe osteoporotic vertebral compressive fracture.

METHODSFrom Junary 2009 to Febuary 2011, 60 patients (70 vertebrae) with osteoporotic vertebral compressive fracture were included. All patients were treated by bilateral transpedicular balloon kyphoplasty combined with postural reduction, including 10 males and 50 females aged from 59 to 90 years old with an average of 72.1 years old. In ordinary osteoporotic vertebral compressive fracture group, there were 38 patients (44 vertebrae) including 7 males and 31 females aged from 59 to 87 years old with an average of (71.8±6.1) years old. There were 6 patients with two vertebral fractures, 1 vertebra in T9, 5 vertebrae in T10, 7 vertebrae in T11, 13 vertebrae in T12, 9 vertebrae in L1, 4 vertebrae in L2, 4 vertebrae in L3, 1 vertebra in L4. While in severe osteoporotic vertebral compressive fracture group, there were 22 patients (26 vertebrae) including 3 males and 19 females aged from 63 to 90 years old with an average of (72.6±7.2) years old. There were 4 patients with two vertebral fractures, 1 vertebra in T9, 2 vertebrae in T10, 3 vertebrae in T11, 9 vertebrae in T12, 6 vertebrae in L1, 3 vertebrae in L2, 2 vertebrae in L3. Operative time, volume of bone cement injection, and vertebral height and changes of Cobb angle before and after operation were observed and compared. Postoperative average recovery rate of vertebral height and correct degree of Cobb angle were caculated and compared, VAS scoring were used to evaluate therapeutic effect.

RESULTSAll operations were completed sucessfully, and pain were relieved at 72 h after operation. All patients were followed up from 6 to 13 months with an average of 10.1 months. Postoperative vertebral height, Cobb angle and VAS score were improved better than that of before operation (P<0.05). Operative time in ordinary group was shorter than severe group, while volume of bone cement injection was more than that of severe group. Average recovery rate of vertebral height and correct degree of Cobb angle in ordinarty group was better than that of in severe group (P<0.05). There was no significant differences between two groups in VAS scores before and after operation (P> 0.05). Three cases (3 vertebrae) ocurred bone cement leakage in ordinarty group, while 5 cases (5 vertebrae) ocurred bone cement leakage in severe group, and there was no meaning between two groups (P>0.05).

CONCLUSIONKyphoplasty could receive satisfied curative effect in treating ordinary and servere patients with osteoporotic vertebral compressive fracture, but recovery of vertebral height and correct degree of Cobb angle in ordinary gourp was better than that of in servere group.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Spinal Fractures ; surgery

Objective Investigation and analysis of intelligence and psychomotor function in children born after implementingt universal salt iodization(USI). Methods Historical serious illness areas of water iodine below 10μg/L were selected as study sites, water iodine in 50 - 100 μg/L in the historical non-endemic areas were as control points in Henan, 2008. Cluster sampling was used to select children aged 6 - 15 years as observing subjects,IQ were measured with CRT- Man Test(CRT-C2). A "Tianjin Medical psychomotor test battery" (JPB) was carry out to test psychomotor function. Results In IDD regions 230 children were surveyed post-USI and 1284 children preUSI. The IQs post and pre USI were 99.3 and 99.9, respectively, and the proportion of IQ ≤69 were 2.17%(6/230) and 2.80%(36/1284), respectively. In non-IDD regions 650 children were surveyed post-USI and 2079children pre-USI. The IQs post and pre USI were 95.3 and 93.8, respectively, and the proportion of IQ ≤ 69 were 2.31%(15/650) and 3.37%(70/2079), respectively. In IDD regions, the abnormal rate of T scores and damage index post USI were 3.6%(2/56), 5.3%(3/56), respectively, significantly lower than pre USI [18.1%(29/160),18.1%(29/160), x2 = 7.54, 6.86, all P ＜ 0.01]. Conclusions USI could increase the IQs of children and decrease the positive rate of JPB, and significantly improve the quality of whole nation and persistently eliminating IDD.

Objective To explore the effect and complication of diode laser and long-pulsed alexandrite laser for hair removal in different skin type.Methods A total of 1061 patients (1741 sites) were divided into 2 groups by skin type:one group were treated with diode laser,with wave length of 810 nm,and pulse width of 400 ms,with 12 mm × 10 mm spot size; another group were treated with long-pulsed alexandrite laser,with wave length of 755 nm,of pulse width of 20 ms,with 12.5 mm spot size,50-60 days intermitted between each treatment.Results The effect of hair removal by two lasers in different skin type was without divergence,but to darker skin,complication was lower when treated by diode laser.Conclusions The effect of hair removal by two lasers in different skin type is similar,but diode laser on hair removal is much safer to dark skin.

Objective To study the expression of interleukin-1β (IL-1β) in synovia and synovium of rats after high intensity exercise.Methods 24 healthy male Sprague-Dawley rats were randomly divided into control group and high intensity group, and the latter were forced to run 60 min at the speed of 28 m/min for 6 weeks. The histological changes of cartilage from the lesion areas of medial femoral condyle and synovium of knee joint were examined with HE stain and the expression of IL-1β in synovium with immunohistochemistry, in synovial fluid with the enzyme-linked immunosorbent assay (ELISA). Results The articular cartilage of knee were injured and synovitis were found in high intensity group. The expression of IL-1β both in synovial fluid and in synovium of the knee were more in high intensity group than in control group (P<0.05). Conclusion High intensity exercise could cause aticular cartilage injury, synovitis and over expression of IL-1β in synovia and synovium, which may associated with post-traumatic osteoarthritis.

Objective To explore the value of echocardiography in the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in children.Methods The echocardiographic images of 14 patients with ALCAPA confirmed by operation and 18 patients with endocardial fibroelastosis (EFE) diagnosed by clinical were compared and analyzed.Results Both ALCAPA and EFE exhibited obvious dilated left ventricle,decreased left ventricular systolic function,thick endocardium and mitral regurgitation of different degree.The former additionally showed dilated right coronary artery(RCA) with normal origin,left coronary artery(LCA) emerging from the root or wall of the pulmonary artery(PA),the retrograde flow into PA in LCA and abundant collateral vessels in myocardium.However the later exhibited normal diameter of LCA and RCA and no collateral vessels.Conclusions Color Doppler echocardiography not only demonstrates left ventricular systolic function,endocardium,mitrial regurgitation and collateral vessels in myocardium,but also shows the origination and courses of LCA clearly,which provide exact informations to diagnose ALCAPA.The echocardiography can be used as a powerful tool of ALCAPA diagnosis and preoperative assessment.

Objective To discuss the expression and mutation of β-catenin gene in breast carcinoma.Methods 119 breast carcinomas, 72 adenosis of breast tissues and 40 normal breast tissues were studied.Using immunohistochemistry studies to detect the expressions of β-catenin, then analyzing their relationship with the clinicopathological features of breast carcinomas. Gene mutation of β-catenin (exon 3) in 44 cases of breast carcinoma were analyzed by polymerase chain reaction (PCR) and then by direct sequencing.ResultsIn 40 cases of normal breast tissues, epithelial cells showed equally strong membranous of β-catenin protein at the cell-cell boundaries. The abnormal rate of β-catenin in breast carcinomas (78.15 %) was much higher than that of adenosis of breast tissues (44.44 %), the significant correlation was found (P＜0.01). The abnormal expression of β-catenin was associated with lymph node metastasis (P=0.031). Mutation of β-catenin gene was not detected in 44 cases of breast carcinoma, while the abnormal rate of β-catenin in 44 cases of breast carcinoma was 77.30 %. Conclusionβ-catenin abnormal expression could be considered as an useful marker for determining metastasis and prognosis of human breast carcinoma and for guiding treatment. β-catenin abnormal expression is not caused by β-catenin gene mutation, maybe by other mechanisms. It needs further study.

Objective To analyze the distribution characteristics and risk factors of extended stay over 30 days at tertiary comprehensive hospitals, and explore methods of shortening average length of stay(LOS).Methods Homepage of all inpatients discharged from October 2014 to October 2015 of 31 tertiary comprehensive hospitals in Shanxi province were collected.39 234 cases of these inpatients stayed over 30 days and their case information was complete.A generalized linear model was used for risk factors analysis.Results With the extension of LOS, most of the inpatients with extended stay were found during their 30th-40th days, accounting for 50.21% of all and constituting the highest daily costs as well.The ratio of inpatients decreases with their LOS, and its distribution presents a positive skew in entirety.Distribution of inpatients over 30 days identified urban employees under medical insurance accounting for the highest ratio among all payment categories,and those from the department of orthopedics for the highest ratio among all departments, while those of diseases from injury and poisoning accounting for the highest ratio among all disease categories.The findings indicated ten important factors for extended stay, namely gender, medical payment category, ICD, inter-department transfer, nosocomial infection, and clinical pathway.Conclusions To strengthen management of specific departments and inpatients, focus on key process of medical quality, and accelerate medical insurance payment reform can effectively control extended stay.

AIM: To analyze the effect of human amniotic homogenate extract on corneal neovascularization after corneal alkali burn in the process of pigment epithelium derived factor (PEDF) and vascular endothelial growth factor (VEGF) expression and the effect of corneal neovascularization.METHODS: Totally 32 patients with corneal alkali burn were selected from June 2015 to June 2016 in Foshan,and were randomly divided into Group A and Group B,with a total of 37 eyes.Group A of 17 cases,with a total of 19 eyes,were treated with 40mg/L human amniotic homogenate extract;Group B (n=15),and 18 eyes,treated with 3g/L prednisolone eye drops.In the treatment of 1,4,7,14,21 and 28d at different time points,we observed the growth of corneal neovascularization,and detected the expression of PEDF and VEGF during angiogenesis.RESULTS: Group A of patients in the use of human amniotic homogenate extract after the treatment,the expression level of PEDF was significantly higher than that in Group B(P=0.001),after 28d treatment,the expression level of PEDF reached 0.721±0.314.While patients in Group B the expression level of PEDF was only 0.538±0.253.Two groups had significant difference between the expression level of PEDF (P<0.05).The expression level of VEGF in Group A was lower than in Group B at different time points in the test.After the treatment of 28d patients in the Group A,the expression level of VEGF was 0.152±0.020,in Group B the expression level of VEGF was0.302±0.031.Two groups of patients with VEGF expression level between the differences were statistically significant (P<0.05).The patients number in Group A with corneal neovascularization was significantly lower than that in Group B,the difference was statistically significant (P<0.05).CONCLUSION: Human amniotic homogenate extract can increase the expression of PEDF in corneal neovascularization after corneal alkali burn,inhibit the expression of VEGF and the proliferation of corneal neovascularization.