Objective To study the relationship among the slow vertex response (SVR) ,tone burst ABR threshold and pure tone thresholds in young people with normal hearing ,and to discuss the values of SVR and tb -ABR assessing hearing thresholds .Methods A total of 30 normal-hearing young people aged 20 to 24 were indud-ed in this study .The thresholds of SVR ,tb -ABR and threshold of PTA were tested at each verbal frequency (0 .5 ,1 ,2 ,4 kHz) .The differences and the relationship among SVR with PTA ,tb-ABR ,and PTA were statistical-ly studied .Results The differences between SVR and tb -ABR and PTA at various frequencies were statistically significant (P<0 .05) .The minimum difference between SVR and PTA was (3 .59 ± 7 .32) dB at 0 .5 kHz .The differences of 1 ,2 ,and 4 kHz were 6 .92 ± 5 .07 ,8 .33 ± 6 .71 ,and 9 .83 ± 9 .41 dB ,respectively .The minimum differences between tb -ABR and PTA was 14 .58 ± 7 .24 dB at 4 kHz ,and the differences of 0 .5 ,1 ,and 2 kHz were 29 .42 ± 6 .83 ,23 .25 ± 7 .47 ,and 16 .50 ± 6 .43 dB ,respectively .SVR and PTA had a good correlation at 1 and 2 kHz (r=0 .51 ,P<0 .01 and r=0 .44 ,P<0 .05 ,respectively) .tb-ABR and PTA had a good correlation at 4 kHz (r=0 .53 ,P<0 .01) .Conclusion In normal hearing young population ,SVR and tb-ABR can estimate PTA well , and the former is closer to PTA threshold .

[Objective]To discuss the causes and preventive measures of early complications after using Vertes technique in treating dens axis fracture with atlantoaxial dislocation.[Method]Eighteen cases performed Vertex technique were included in this study.The early complications(postoperative or at surgery) included vertebral artery injury(2 cases),logagnosia(1 case),anopsia(1 case),hematorrhea(1 case) and wrong instrumentation(1 case).The causes of these complications and how to prevent were analyzed.[Result]All these complications were treated in time,and no sequela was found.[Conclusion]The early complications of Vertex technique in treating dens axis fracture with atlantoaxial joint dislocation can be prevented.The timely treatment must be performed when it occurs,and the effect would be satisfactory.

This paper is aimed to explore the correlation of clinical outcomes with material science features of implant in the treatment of atlantoaxial instability by the Vertex technique.A total of 26 cases with atlantoaxial instability and dislocation were enrolled from the Affiliated Hospital of Luzhou Medical College between January 2004 and January 2006.They all underwent the internal fixation via posterior cervical pathway and atlantoaxial fusion in Vertex system that was produced by American Sofamor Danek Company.The intraoperative complications and postoperative neurological recovery of each case were documented.Dynamic radiograph and digital tomography were used to evaluate the extent of the atlantoaxial vertebrae stability.①The result of X-ray showed that bony fusion was successful in 22 patients during 3-month follow-ups,3 patients during 6-month follow-ups,and 1 case after implantation following bony resorption.②There was no deterioration of spinal cord injury and the JOA scores of neurofunction increased from 3-17 points(mean 6.8 points) to 5-17 points(mean 14.8 points) ,with the rate of improvement as 83%.③All 26 patients were normal in the movements of expansion and flexion,but the rotation was partly limited.There were 18 cases rotate in 120?,6 cases in 100? and 1 case in 60?.Vertex system is effective in dealing with internal fixation via posterior cervical pathway.Due to the connection with stick by multiaxial screw,Vertex system presents superiority in clinic,such as secure fixation,random length and convenient connection.Vertex system internal fixation is effective in dealing with atlantoaxial instability and dislocation.

Objective To evaluate the clinical value of a novel anvil insertion technique in intracorporeal esophagojejunostomy and esophagogastrostomy after laparoscopic total or proximal gastrectomy.Methods A total of 40 patients with gastric cancer underwent laparoscopy-assisted radical total or proximal gastrectomy with lymph node dissection,followed by esophagojejunostomy or esophagogastrostomy using a reverse anvil insertion technique (the observation group,n =22) or traditional open surgery technique (the control group,n =18).Data of the two groups were compared.Results In observation group,laparoscopic total gastrectomy and esophagojejunostomy were successfully performed in 17 patients,laparoscopic proximal gastrectomy and esophagogastrostomy were successfully performed in the 5 patients,and no conversion to open surgery occurred.The mean time of operation was (272.0 ±49.8)min,including (12.9 ±4.3)min for anvil insertion and (48.1 ± 12.8)min for digestive tract reconstruction,which were significantly shorter than those in control group (P ＜ 0.05).The mean time of getting out of bed in observation group was (3.4 ± 0.8) d,the mean time of post-surgical eating was (8.0 ± 2.6) d,and the mean time of hospitalization was (10.8 ±3.3)d,which were all similar with those from the control group (P ＞0.05).Conclusion The reverse anvil insertion technique is a reliable strategy for laparoscopic esophagojejunostomy or esophagogastrostomy.

Objective To explore the vitamin D nutritional status of urban residents in Jinan,in order to provide the basis for the prevention and treatment of chronic diseases associated with vitamin D insufficiency.Methods 1478 cases aged 30-90 years,including 602 men (59.8± 13.0) years on average and 876 women (57.4±12.9) years on average were selected by a stratified random sampling from 3 community medical care institutions in Jinan.Subjects were divided into six groups according to the 10-year interval.Serum 25-hydroxyvitamin D [25(OH) D] level was measured by enzyme-linked immunosorbent assay (ELISA).Serum [25(OH) D] level ≥ 75 nmol/L was defined as vitamin D sufficient,(50.0 ～ 74.9) nmol/L as vitamin D critical value,25.0 ～ 49.9 nmol/L as vitamin D insufficiency,＜ 25 nmol/L as vitamin D deficiency.All data processing and statistical analysis were finished by SPSS 13.0.Results The average level of [25 (OH) D] was 58.60 nmol/L in males [95％ CI:56.7-60.5 nmol/L] and 54.17 nmol/L in females [95％ CI:52.8-55.8 nmol/L],which were less than 75 nmol/L.The average level of [[25(OH) D] was 49.1nmol/L in females aged 70-79 years (95％CI:45.7～52.5 nmol/L),41.7 nmol/L in females aged 80-90 years (95％CI:38.2 ～46.7 nmol/L),which were less than 50 nmol/L.The percentage of cases with vitamin D deficiency,insufficiency,critical value,and sufficiency was 5.6％,33.4％,36.5％,24.4％ in males,and 6.5％,42.9％,32.6％,18.1％ in female respectively.The incidence of vitamin D deficiency and insufficiency was increased with ageing (male:x2 =33.68 P＜0.01,female:x2 =55.7,P＜0.001).The percentage of vitamin D deficiency and insufficiency was more in females than in males (60-69 years old:x2=9.387,P＜0.05,80-90 years old:x2=8.896,P＜0.05).The [25 (OH) D] level was lowest in winter (48.8 nmol/L,95％CI:46.8～50.9 nmol/L) and highest in autumn (60.2 nmol/L,95％ CI:58.0～62.3 nmol/L).The incidence of vitamin D deficiency and insufficiency was highest in winter (x2 =18.364,P＜0.05).Conclusions Vitamin D deficiency and insufficiency are widely prevalent in urban residents,which is more severe in the elderly and females.Serum [25(OH) D] level is related to season,and the vitamin D deficiency and insufficiency are severe in winter.

Objective To summarize the efficacy of cervical pedicle screw fixation in the treatment of cervical spinal cord injury without fracture and dislocation.Methods From September 2007 to March 2010,21 patients with cervical spinal cord injury without fracture and dislocation combined with developmental cervical stenosis were managed by pedicle screw fixation in unstable segments,and then single open-door laminoplasty in stenosis segments.The clinical outcomes were reviewed and summarized.Results All the patients received follow-up of 1-3 years.Two patients had superficial wound infection,which was cured by dressing change.One presented intra-incisional hematoma one week post-operatively and was cured by hemostasis and drainage.One had door-reclosing without symptom aggravation.There was neither perforation of pedicle screws nor breakage,loosening or displacement of internal fixation.The curvature of cervical lordosis at follow-up had significant rectification in comparison with that at preoperation,but showed unobvious change as compared with that immediately after operation.According to the modified Japanese Orthopedic Association (JOA) score,the neurological score improved from preoperative 4-15 points to 9-17 points at the final follow-up,which revealed more than 80％ of recovery in 13 patients,50％ -80％ of recovery in six and 5％ -50％ of recovery in two,with the average recovery rate of 75％.Conclusion For unstable segments in patients with cervical spinal cord injury without fracture and dislocation combined with developmental spinal stenosis,posterior pedicle screw fixation can avoid the risk of further spinal cord injury in single open-door laminoplasty and restore the physiological curvature of cervical vertebrae,which provides solid foundation for backward drift of spinal cord and creates favorable condition for recovery of spinal cord function.

AIM:To investigate the impact of various levels of glucose on endothelial progenitor cells (EPCs) proliferation, senescence, and nitric oxide (NO) secretion,and the effect of insulin under high glucose conditions.METHODS: Mononuclear cells were collected from rat bone marrow by density gradient centrifugation, cultured with medium 199, and identified to be EPCs at 7th day by flk-1 and AC133 double staining. EPCss were harvested and incubated with glucose (5, 10, 20, 40 mmol/L) or insulin (0.1, 1, 10, 100 nmol/L) under high glucose conditions for 24 h or 7 days. Proliferative capacity, senescence level and NO secretion (after 24 h of incubation) were subsequently determined.RESULTS: High glucose (40 mmol/L) markedly inhibited EPCs proliferation, accelerated EPCs senescence, and decreased NO production (all P

Objective To find the microorganisms which hydrolyze sugar residues of steroidal saponins at C-3 position and to obtain their glucosyl-derivatives.Methods The enzymes secreted by fermentation of Curvularia lunata((3.438 1)) in the culture medium were employed to transform polyphyllin Ⅴ(compound Ⅰ) and polyphyllin Ⅵ(compound Ⅱ).The products were separated by means of chromatography on C_(18) column and their structures were elucidated on the basis of spectral analyses.Results Compounds Ⅰ and Ⅱ could be transformed by C.lunata((3.438 1)) and the main products were identified as diosgenin-3-O-?-D-glucopyranoside,named trillin(compound Ⅲ) and pennogenin-3-O-?-D-glucopyranoside(compound Ⅳ),respectively.Conclusion The terminal rhamnosyls of polyphyllin Ⅴ and polyphyllin Ⅵ at C-3 position could be hydrolyzed selectively by C.lunata((3.438 1)) for the first time.

OBJECTIVE To study the carbapenemase genotypes among Acinetobacter calcoaceticus isolates infected after liver transplantation. METHODS The 5.4 software was used to analyze the resistance of Acinetobacter species. Eight strains of imipenem-resistant A. calcoaceticus which were resistant to multiple drugs were collected. Analytical isoelectric focusing electrophoresis was used to measure the pI of the ?-lactamase. The homology of the isolates was determined by pulsed field gel electrophoresis(PFGE). blaTEM, blaSHV, blaIMP, blaVIM, blaOXA Genes for resistant isolates were amplified and sequenced. RESULTS Imipenem-resistant A. calcoaceticus infected after liver transplantation was resistant to multiple drugs. All of 8 strains were produced OXA-23 carbapenemases (pI of 6.7). The results of PFGE indicated there was a trend of resistant clone transmisstion in the transplantation ward. CONCLUSIONS There is a transmisstion of A. calcoaceticus producing OXA-23 carbapenemase in the transplantation ward of our hospital. It is important to monitor powerfully the bacterial resistance to control infection more effectively.

OBJECTIVE: Understand the changes before and after treatment in patients with severe OSAHS serum S100β protein, NSE levels and cognitive function. To investigate the molecular mechanisms of cognitive dysfunction in patients with severe OSAHS. Serum S100β protein, NSE levels and cognitive function were examined before and after the therapy. METHOD: Select one hundred patients diagnosed as severe OSAHS were included, by polysomnography (PSG) diagnosis of severe OSAHS patients. Determination of serum S100β protein, and NSE levels and theat the same time be MoCA score were checked at after the day after admission, CPAP treatment for the 7th days after CPAP treatment and the 90th day after, comprehensive treatment in these patients for 3 months. Assessment of severe OSAHS patients with serum S100β protein, NSE basic level and MoCA score situation. Comparison of three groups serum S100β protein, NSE levels and MoCA score changes. Serum S100β protein, NSE detection assay (ELISA) method using enzyme-linked immunosorbent. RESULT: (1) Severe OSAHS patients with serum S100β protein, and NSE levels in severe OSAHS patients were positively correlated with AHI, but negatively correlated with lowest oxygen saturation (LSaO2); (2) MoCA score in patients with severe OSAHS was significantly negatively correlated with AHI, but positively correlated with LSaO2; (3) S100β protein, NSE levels were negatively correlated with MoCA score; (4) Compared with admission, serum S100β protein, and NSE levels in these patients have declined after 7 days CPAP therapy, compared with admission the difference was statistically significant (P < 0.05). After 3 months of comprehensive treatment, patients' serum S100β protein and, NSE levels were significantly decreased, compared with the admission and the 7th days after CPAP treatment. The difference was statistically significant (P < 0.05). (5) After CPAP treatment for 7 days, the MoCA scores were slightly higher, but have there was no statistically significant difference compared with the admission (P > 0.05). After 3 months of comprehensive treatment, MoCA score improved significantly, compared with the admission and 7 days after CPAP treatment the difference was statistically significant (P < 0.05). CONCLUSION Comprehensive treatment can reduce serum S100β protein, and NSE levels, and improve MoCA score. Disease severity in patients with OSAHS have a correlation some relative.with the serum S100β protein, NSE levels and MoCA score. Long-term hypoxemia and the structure of sleep disorders may be the cause of elevated serum S100β protein, NSE levels elevated and causes of cognitive dysfunction. Comprehensive treatment can improve patient hypoxemia, correct disorders of sleep structure ,and can improve cognitive function and to improve the quality of life of patients.
Cognition Disorders ; blood ; etiology ; Continuous Positive Airway Pressure ; Humans ; Polysomnography ; Quality of Life ; S100 Calcium Binding Protein beta Subunit ; blood ; S100 Proteins ; blood ; Sleep Apnea, Obstructive ; blood ; therapy