Neuronal damage is associated with the excessive stimulation of N-Methyl-D- Aspartate (NMDA) receptors by glutamate during cerebral ischemia.Because of non-selective NMDA receptor antagonist can influence all NMDA receptors and produce adverse effects,and its clinical application has been restricted significantly,an increasing attention has been paid to the selective NMDA receptor in recent years.NR2B subunit antagonists are mainly divided into piperidine derivatives,amide derivatives,amidine derivatives,and aminoquinoline derivatives,etc. The representative drugs include ifenprodil and eliprodil.These drugs can selectively act on NMDA receptor NR2B subunit,and they are expected to become safe and effective neuropro- tective agents in clinical practice.

Objective To observe the analgesic effect of ultrasound-guided and nerve stimulator after artificial total knee athroplasty(TKA).Methods Forty elective cases receiving TKA under gen-eral anesthesia were randomly allocated into the ultrasound group (group C)and stimulator group (group S).The time for nerve block,onset time and complications were recorded in both groups. Results Compared to group S,the time for nerve block and onset time was significantly shortened in group C (P <0.05).There was no statistical difference in times of pressing analgesic pump and VAS score in postoperative 48 h.One patient suffered from nerve injury and two underwent vascular dam-age and hematoma in group S,while no complication was found in group C.Conclusion Compared to nerve stimulator,ultrasound-guided continuous femoral nerve block(CFNB)may reduce nerve block time and onset time and decrease complications,so that to increase safety of CFNB.

Objective To explore the clinical modalities and diagnosis of respiratory failure due to laryngotracheal disorders in children,in order to reduce the misdiagnosis.Methods Fifteen patients(11 cases were male,4 cases were female) with respiratory failure in Intensive Care Unit, Tianjin Children′s Hospital from Jul.2006 to Jul.2009 were selected.Data including history,characteristics and results of spiral computerized tomography(CT) and reconstruction and magnetic resonance imaging(MRI) were reviewed.Results The major clinical manifestations indicated that 7 cases had laryngeal stridor,6 cases had recurrent pneumonia,5 cases had cyanosis after crying,and 12 patients were complicated with respiratory failure in 12 hours.Nine cases were recovered,3 cases were given up,and 3 cases died.All patients were performed with CT about laryngohypopharynx,and the results were cyst of root of tongue in 3 cases,trachea pressed by cyst of parapharyngeal space in 1 case.There were 11 cases examined by spiral CT and reconstruction,in which 6 cases were confirmed as tracheal stenosis,2 cases were left bifid tracheostoma,2 cases were pulmonary artery sling,and 1 case was diagnosed as tracheomalacia.Chest X-ray radiograph indicated that bronchopneumonia in 8 cases,bronchitis in 3 cases and negative in 4 cases.Echocardiograph examination was performed among 11 cases,in which 2 cases were pulmonary artery sling,2 cases were atrial septal defect,1 case was patent ductus arteriosus, and 6 cases were negative.Conclusions There is high morbidity of respiratory failure caused by laryngotracheal disorders in infants,but misdiagnosis ccures usually because of non-specific symptoms.If the infant must depend on mechanic ventilation for a long time and has airway obstruction,he should be examined early by using spiral CT.

Adrenal Gland Neoplasms ; metabolism ; pathology ; surgery ; Adult ; Diagnosis, Differential ; Female ; Hormones, Ectopic ; secretion ; Humans ; Inhibins ; metabolism ; Keratin-8 ; metabolism ; Myelolipoma ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; secretion ; surgery ; Vimentin ; metabolism

Objective To observe the immunologic effect of lactoferrin on repeated respiratory infection(IRRI) in children.Methods Ninety-eight cases of IRRI were divided into two groups randomly.The control group (48 cases)were treated with routine therapy.The treatment group(50 cases) were treated with lactoferrin based on routine therapy for 2-3 months.T cell subgroup,immunoglobulin and complements were determined before and after treatment.Results Total effective rates in treatment group and control group were 86% and 22.9% respectively.The therapeutic efficacy in treatment group was significantly higher than that in control group(P

Objective To perform a biomechanical study on and compare the stability of internal fixation with closed Kirschner wire in different spots from the epicondylus medialis to sulcus nervi ulnaris and epicondylus lateralis of humerus in the treatment of GartlandⅢsupracondylar fractures of humerus in children in order to provide basis for avoiding cubitus varus in clinic.Methods Twenty models of su- pracondylar fractures were made from ten humerus samples,then divided into two groups(group A and group B).They were fixed with closed Kirschner'wires.Ulnar Kirschner wire varied.In group A five spots were selected averagely from the epicondylus medialis to the sulcus nervi ulnaris.Kirschner wires entered from one of the five spots into another spot of humerus.In group B Kirschner wires entered defferent spots of humerus from the central spot of sulcus nervi ulnaris.Biomechanical tests were carried out,such as axial load,axial displacement,stress intensity,axial rigidity and anti-twisty ability.Forty-six children with Gart- landⅢsupracondylar fracture of humerus were treated and followed up for more than one year.Results In beth groups,with the angle of Kirschner wires and fracture side increasing,the strain and the vertical displacement decreased,the stress intensity and the axial rigidity increased,and the anti-twists ability was enhanced.There was statistic difference(P＜0.05).The follow-up of the 46 patients showed the elbow joint function recovered well with no cubitus varus malformation.Conclusion Internal fixation with closed Kirschner wires in sulcus nervi ulnaris from the epicondylus medialis and the epicondylns lateralis of humerus for GartlandⅢsupracondylar fracture of humerus in children has the advantages of enhancing bio- mechanical stability,effective prevention of secondary replacement of outlying black of the fracture and a- voidance of cubitus varus.It can be widely used clinically.

Objective To investigate the risk factors associated with the death of pediatric septic shock,for improving prognosis and decreasing mortality.Methods Sixty-four patients in intensive care unit diagnosed as septic shock were enrolled from Apr.2002 to Apr.2008.The factors such as age,sex,C-reacted protein,WBC,platelet count,blood glucose,procalcitonin(PCT),serum lactic acid,pediatric critical illness score(PCIS),ventilator using and complication of multiple organ dysfuction syndrome(MODS) were researched,these research factors were analyzed by univariate analysis,then to be analyzed by Logistic regression.Results The mortality was 59.38%(38/64 cases).Twenty patients with severe septic shock were all died.Thirty-four patients had breath failure and 26 cases had MODS,the mortality were 62.50%,76.92%,100.00% in patients complicated with 2,3,4 organs dysfunction.In the univariate analysis,variables significantly associated with death in septic shock were PCT,lactic acid,PCIS,MODS.In the Logistic regression,variables significantly associa-ted with death were PCT,lactic acid,PCIS and MODS.Conclusions The mortality of septic shock was high,and decreased PCIS,elevated serum lactic acid level and PCT,and multiple organ dysfuction are the risk factors associated with the death of septic shock.

AlM: To study the clinical effect of the application of microscopic pterygium resection combined with different concentration of mitomycin C ( MMC) .
METHODS:A total of 110 cases of pterygium patients (120 eyes) were randomly divided into control group (58 eyes) and observation group (62 eyes) according to the odd and even number method. The control group adopted the pterygium resection combined 0. 3mg/mL MMC, and the observation group was given pterygium resection combined 0. 2mg/mL MMC. The cure rate and the recurrence rate, eyesight before and after the treatment, two groups of cornea and sclera wound healing situation, the incidence of postoperative complications were compared.
RESULTS: The cure rate and recurrence rate of the control group was 84. 5% and 15. 5% respectively, and the observation group was 93. 6% and 6. 5% respectively, the differences were statistically significant (P<0. 05). There were statistical differences of vision of the two groups before and after treatment (P<0. 05), and there were no statistical differences of the two groups between the two groups after treatment (P>0. 05). The cornea, sclera, wound healing time of the observation group were less than the control group, and there were statistical differences between the two groups ( P < 0. 05 ). The incidence of complications was 13. 8% in the control group and 3. 2% in observation group, with statistically significant difference (P<0. 05).
CONCLUSlON: The application effect of microscopic pterygium resection combined with MMC is remarkable, and the joint of 0. 2mg/mL concentration of MMC is more safe and effective, and is worth popularizing in clinical application.

Objective To investigate the differentiation of neuroendocrine component (NEC) in colorectal adenocarcinoma in relation to its significance by comparing the outcome between patients with or without NEC.Methods The paraffin sections from patients with pathologically confirmed colorectal adenocarcinoma were retrospectively collected and screened for those with NEC by morphological examination and immunohistochemistry with neuroendocrine markers.Control patients (n=54) without NEC were selected from colorectal cancer database and 2: 1 matched on the basis of clinical features with NEC positive patients (n=27).Relative analysis was performed between two groups.Results With a median follow-up of 72 months,the 5-year disease free survival was 58.0% (16/27) in NEC positive group and 79.1% (43/54) in control group (P=0.036).Similarly,the 5-year cancer-specific overall survival was significantly lower in NEC positive group than in control group (58.3% versus 81.1%,P=0.037).Cox regression showed that the 5-year cumulative risks of disease recurrence and cancer-caused death in NEC positive patients were 2.38 and 2.41 times higher than those in control patients,respectively.Conclusions NEC appears to bear a poor prognosis in patients with colorectal adenocarcinoma.

Objective To evaluate the clinical value of speckle tracking imaging in the measurement of two-dimensional strain in patients with myocardial infarction. Methods High frame rate two-dimensional echocardiography were performed in 30 healthy subjects,21patients with anterior myocardial infarction and 15 patients with inferior myocardial infarction. Longitudinal strain (LS), radial velocity (Vs), regional shortening fraction (RFS),radial strain (RS) were measured in the apical two-chamber view and short-axis view(the level of papillary muscle) using two-dimensional strain software. Results Compared with healthy subjects, LS, Vs, RFS, RS decreased in the segments with infarction(P<0.05). LS, Vs, RFS, RS of the two myocardial infarction groups had partly differences(P<0.05). Conclusions Regional wall motion of left ventricle in patients with myocardial infarction can be evaluated accurately with speckle tracking imaging.