ObjectiveTo investigate the practicability of gastric intubation with zebra-guidewire under the induction of anesthesia with sevoflurane (zebra-guidewire was the obsolete guide wire in percutaneous nephrolithotomy in urology surgery). MethodsThe patients who needed gastric intubation were randomized into the experimental group and the control group with 20 patients in each group.the experimental group received gastric intubation with zebra- guidewire under the induction of anesthesia with sevoflurane.In the control group,the gastric tubes were catheterized with routine method.The physiological indices changes,incidence rate of adverse reaction and success rate of one-time catheterization and average time of catheterization per patient were compared between the two groups. ResultsIn patients of the experimental group,the blood pressure,heart rate before and during the intubation did not fluctuate evidently,but in the control group the results were the opposite.In the experimental group the incidence rate of adverse reaction,success rate of one-time catheterization and average time of catheterization per patient were superior to the control group. ConclusionsGastric intubation under the induction of anesthesia with sevoflurane was a painless way of gastric intubation.Gastric intubation with zebra-guidewire under anesthesia state was simple and fast.

Objective To explore the relationship of estradiol(E_2),monoamine neurotransmitters 5-hydroxytryptamine(5-HT),dopamine(DA)and postpartum depression.Methods Totally 342 women within 42 days after childbirth were assessed with Edinburgh postnatal depression scale(EPDS),Beck depression inventory(BDI),and general health questionnaire(GHQ).Above or equal to 13 of overall score of EPDS was the diagnosis standard of postpartum depression,and the women tested were divided into depression group and normal group accordingly,using the reagent box of radio immunoassay to test estradiol and 5-HT and DA level in the serum.Results(1)Incidence:the incidence of postpartum depression was 16.7%(57/342).The highest incidence occurred in patients above 35(22.2%);the incidence among women under 23 years old was lowest(12.5%),with a significant difference between them(P0.05). Conclusions Evaluation scales such as EPDS,BDI,and GHQ should be used to screen for postpartum depression.The measurement of estradiol and monoamine neurotransmitter(5-HT,DA)level can be used as biological objective indicators for prevention and treatment of postpartum depression.

BACKGROUNDIn tumors the process of apoptosis occurs over an interval of time after chemotherapy. It is important to determine the best time for detecting apoptosis by in vivo imaging. In this study, we evaluated the dynamics and feasibility of imaging non-small cell lung cancer (NSCLC) apoptosis induced by paclitaxel treatment using a (99)Tc(m)-labeled Annexin V recombinant with ten consecutive histidines (His10-Annexin V) in a mouse model.

METHODS(99)Tc(m)-His10-Annexin V was prepared by one step direct labeling; radio-chemical purity (RCP) and radio-stability was tested. The binding of (99)Tc(m)-His10-Annexin V to apoptotic cells was validated in vitro using camptothecin-induced Jurkat cells. In vivo bio-distribution was determined in mice by dissection. The human H460 NSCLC tumor cell line (H460) tumor-bearing mice were treated with intravenous paclitaxel 24, 48 and 72 hours later. (99)Tc(m)-His10-Annexin V was injected intravenously, and planar images were acquired at 2, 4 and 6 hours post-injection on a dual-head gamma camera fitted with a pinhole collimator. Tumor-to-normal tissue ratios (T/NT) were calculated by ROI analysis and they reflected specific binding of (99)Tc(m)-His10-Annexin V. Mice were sacrificed after imaging. Caspase-3, as the apoptosis detector, was determined by flow cytometry, and DNA fragmentation was analyzed by the terminal deoxynucleotidytransferase mediated dUTP nick-end labeling (TUNEL) assay. Nonspecific accumulation of protein was estimated using bovine serum albumin (BSA). The imaging data were correlated with TUNEL-positive nuclei and caspase-3 activity.

RESULTS(99)Tc(m)-His10-Annexin V had a RCP > 98% and high stability 2 hours after radio-labeling, and it could bind to apoptotic cells with high affinity. Bio-distribution of (99)Tc(m)-His10-Annexin V showed predominant uptake in kidney, relatively low uptake in myocardium, liver and gastrointestinal tract, and rapid clearance from blood and kidney was observed. The T/NT was significantly increased after paclitaxel treatment, whereas it was low in untreated tumors (T/NT = 1.43 ± 0.18). The %ID/g activity in Group 2 (24 hours), Group 3 (48 hours) and Group 4 (72 hours) after treatment was 2.55 ± 0.73, 3.35 ± 1.10, and 3.4 ± 0.96, respectively. Whereas in the non-treated group, Group 1, %ID/g was 1.10 ± 0.18. The radiotracer uptake was positively correlated to the apoptotic index (r = 0.852, P < 0.01), as well as caspase-3 activity (r = 0.816, P < 0.01).

CONCLUSIONThis study addresses the dynamics and feasibility of imaging non-small cell lung tumor apoptosis using (99)Tc(m)- His10-Annexin V.

Animals ; Annexin A5 ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Apoptosis ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cell Line, Tumor ; Disease Models, Animal ; Histidine ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Mice ; Organotechnetium Compounds ; Paclitaxel ; therapeutic use ; Radiopharmaceuticals

OBJECTIVETo assess the effect of the different treatments targeted at different types of radial head fracture and radial neck fracture.

METHODSA retrospective study was performed in 87 patients from February 2006 to March 2007. Fifty-four patients with radial head fractures included 36 males and 18 females, aged from 18 to 65 years (the average age was 33); Forty of them resulted from crashing, 8 from traffic injury and 6 from falling injury. According to Mason classification system, there were 15 type I, 23 type II and 16 type III. Thirty-three patients with radial neck fractures included 21 males and 12 females, aged from 9 to 17 years (the average age was 13), 29 of them resulted from crashing, 1 from traffic injury and 3 from falling injury. According to O'Brien classification system, there were 8 type I, 14 type II and 11 type III. Type I of radial head fractures and radial neck fractures were immobilization with cast, the patients with type II of radial head fractures were treated with open reduction and micro-screw or T-trapezoid and bridge-shaped plate fixation and type III had operations to fix with bridge-shaped locked plate and repair the broken annular ligament, or replace heads with prosthesis. All patients with type II and type III of radial neck fractures were treated with closed reduction by leverage and percutaneous intra-medullary nailing.

RESULTSThe patients were followed up for 4-12 months (mean 7.2 months). The functional recovery degrees were evaluated with Wheeler's evaluation system. In group of radial head fractures, the results were excellent in 26 patients, good in 20, fair in 6 and poor in 2, the excellent and good rate was 85.2%. In group of radial neck fractures, the results were excellent in 20 patients, good in 9, fair in 4 and poor in no patient, and the excellent and good rate was 87.9%.

CONCLUSIONSDifferent types of fractures should choose different surgical methods according to their characters. The excellent functional recovery depend on anatomical reduction, retaining the head of radius, early repairing and protecting the broken annular ligament of radius, and early functional training.

Adolescent ; Adult ; Aged ; Arthroplasty, Replacement ; Bone Plates ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the morbidity of soldiers stationed on an island ,analyze the relationship betweendiseases and the environment,and to provide an effective method for disease prevention and treatment .Method Data ofoutpatients from troops stationed on an island between September 2012 and August 2013 were statistically investigatedaccording to the classification of diseases.The cause of disease was analyzed .In addition,90 soldiers stationed on an islandwere randomly selected to investigate their response to heat and humidity and parts susceptible to skin diseases viaquestionnaires and talks.Results A total of 789 cases of disease were identified,including 226 cases of upper respiratorytract infection,118 cases of orthopedic-related diseases,90 cases of traumatic diseases,88 cases of oral diseases,74 casesof digestive system diseases,62 cases of skin diseases,53 cases of ENT diseases,41 cases of urinary tract infection,and37 cases of anorectal diseases.The top five responses to heat and humidity were sweating,thirst,body fatigue,dizzinessand profuse sweating.The most susceptible part to skin diseases was the feet ,followed by the cheek,crotch,back andneck.Conclusion The epidemiological characteristics of diseases on this island are significant,and medical supportshould be focused on improving the overall level of hospital treatment.

Both chronic obstructive pulmonary disease (COPD) and sudden cardiac death (SCD) are major health burdens.In conclusion,cumulating evidence associates COPD with an increased risk of SCD.First,it is found that asystole and pulseless electric activity(PEA)are more common than ventricular tachycardia/ventricular fibrillation(VT/VF)in deaths associated with COPD in studying interrelationship between COPD and ventricul ararrhythmias and cardiac arrest. The underlying mechanism explaining this association requires further investigation.Second,it is found that COPD is associated with a prolonged and shortened QT interval in studying the role of ECG markers between SCD and COPD.Finally,studies of the potential impact of respiratory treatment on the occurrence of SCD showed conflicting results.Accurate prediction of SCD in the general population is still a challenge. The risk assessment of SCD might be guided by studying the link between COPD and SCD.

BACKGROUNDUnstable pelvic fractures are complex and serious injuries. Selection of a fixation method for these fractures remains a challenging problem for orthopedic surgeons. This study aimed to compare the stability of Tile C pelvic fractures fixed with two iliosacral (IS) screws and minimally invasive adjustable plate (MIAP) combined with one IS screw.

METHODSThis study was a biomechanical experiment. Six embalmed specimens of the adult pelvis were used. The soft tissue was removed from the specimens, and the spines from the fourth lumbar vertebra to the proximal one-third of both femurs were retained. The pubic symphysis, bilateral sacroiliac joints and ligaments, bilateral hip joints, bilateral sacrotuberous ligaments, and bilateral sacrospinous ligaments were intact. Tile C pelvic fractures were made on the specimens. The symphysis pubis was fixed with a plate, and the fracture on the posterior pelvic ring was fixed with two kinds of internal fixation in turn. The specimens were placed in a biomechanical machine at a standing neutral posture. A cyclic vertical load of up to 500 N was applied, and displacement was recorded. Shifts in the fracture gap were measured by a grating displacement sensor.

STATISTICAL ANALYSIS USEDPaired-samples t-test.

RESULTSUnder the vertical load of 100, 200, 300, 400, and 500 N, the average displacement of the specimens fixed with MIAP combined with one IS screw was 0.46, 0.735, 1.377, 1.823, and 2.215 mm, respectively, which was significantly lower than that of specimens fixed with two IS screws under corresponding load (P < 0.05). Under the vertical load of 500 N, the shift in the fracture gap of specimens fixed with MIAP combined with one IS screw was 0.261 ± 0.095 mm, and that of specimens fixed with two IS screws was 0.809 ± 0.170 mm. The difference was significant (P < 0.05).

CONCLUSIONThe stability of Tile C pelvic fractures fixed with MIAP combined with one IS screw was better than that fixed with two IS screws.

Adult ; Bone Screws ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; surgery

UNLABELLEDObjective To evaluate the efficacy of 99mTc-labeled C2A probe in detection of apoptosis of non-small cell lung cancer (NSCLC) cells after chemotherapy.

METHODSImaging studies were performed in NSCLC H460-bearing mice. The mice were divided into 2 groups: the paclitaxel-treated group and control group. 99mTc-C2A was injected intravenously at 12, 24, 48 and 72 h after chemotherapy. Images were acquired at 3 h and 6 h after injection using a pinhole collimator. The regions of interest (ROI) were drawn in tumor area and contralateral nomal tissue, and the ratio of T/NT were caculated. The tumor sections were stained by HE and TUNEL (terminal deoxynucleotidyltransferase-mediated dUTP-nick-end labeling) staining to confirm the presence of apoptosis. Activated caspase-3 was also analyzed with flow cytometry.

RESULTSLittle uptake of 99mTc-C2A was found in baseline images, but tumor uptake increased very much after chemotherapy, the T/NT ratio was 1.79 +/- 0.34, 2.23 +/- 0.33 and 2.78 +/- 0.34, respectively. The T/NT ratio of control was 1.48 +/- 0.23. Tumor uptake (% ID/g) of 99mTc-C2A in chemotherapy groups were 2.82 +/- 0.90, 3.13 +/- 0.48 and 3.52 +/- 1.18, respectively. Tumor uptake (% ID/g) in the control group was 1.21 +/- 0.51. It in paclitaxel-treatment groups were 2.82 +/- 0.90, 3.13 +/- 0.48 and 3.51 +/- 1.18, respectively, significantly higher than that in untreated mice. Furthermore, the uptake of 99mTc-C2A correlated well with apoptotic index (r = 0.56, P < 0.01), and activated caspase-3 (r = 0.59, P < 0.01).

CONCLUSIONOur preliminary results demonstrated that 99mTc-C2A imaging in vivo for detection of cell death in solid tumors is feasible and well correlated with TUNEL staining and activated caspase-3. The C2A holds promise and warrants further development as a molecular probe to early predict cancer treatment efficacy.

Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; therapeutic use ; Apoptosis ; drug effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; pathology ; Caspase 3 ; metabolism ; Flow Cytometry ; Humans ; In Situ Nick-End Labeling ; Lung Neoplasms ; drug therapy ; metabolism ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Paclitaxel ; pharmacology ; therapeutic use ; Synaptotagmin I ; chemistry ; metabolism ; Technetium ; administration & dosage ; chemistry ; Xenograft Model Antitumor Assays

Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduction and intramedullary nail fixation to determine the therapeutic effect of this closed reduction technique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a gentle traction was attempted on the limb. Usually, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the medullary cavity, and the "T" sharp handles were fixed on the Schanz pins. The fragments were then reduced by reversing the deforming forces for segmental fractures by two assistants. And then, the reduction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all patients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen (86.7%) patients had anatomic reduction and two of them (13.3%) had minor varus alignment of 3° and 5°. Knee stiffness was observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures with four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.
Adult ; Bone Nails ; Femoral Fractures ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography

OBJECTIVETo investigate the techniques and curative effects of transcatheter artery embolization (TAE) for massive bleeding due to pelvic fractures.

METHODSThe clinical data of 92 patients with haemorrhage due to pelvic fractures from March 1998 to February 2008 were retrospectively analyzed. Among 53 patients treated conservatively such as massive transfusion and fluid infusion in the control group, 43 patients were male and 10 patients were female, ranging in age from 27 to 61 years, averaged (37.2 +/- 5.7) years. Among 39 patients who were hemodynamically unstable or had evidences of ongoing hemorrhage required TAE, 26 patients were male and 13 patients were female, ranging in age from 26 to 62 years, with a mean age of (35.3 +/- 9.5) years. The clinical date such as blood or fluid transfusion volume, shock redress time and survival rate were compared between the two groups. The hemostatic efficiency and complications of the surgery were also analyzed.

RESULTSThe average hemostasis time of TAE group was 2 hours. There were no intraoperative injuries of blood vessels, nerve or vital organs. Three patients had lower limbs numbness and 5 patients had gluteal skin redness after the operation. The blood transfusion or fluid infusion volume, shock redress time and survival rate were all significantly better than those in the conservative group.

CONCLUSIONSTAE is an early,rapid and effective method in controlling haemorrhage due to pelvic fractures.

Adult ; Case-Control Studies ; Embolization, Therapeutic ; methods ; Female ; Fractures, Bone ; complications ; therapy ; Hemorrhage ; therapy ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries