Objective To explore the molecular mechanism of osteoblast apoptosis mediated by glucocorticoid, provide experimental basis for clinical prevention and treatment of hormonal necrosis of femoral-head.Methods The MC3T3-E1 cells were divided into control group and three treatment group treated with different concentrations of dexamethasone (1, 10, 100μmol/L) for 24 hours.The apoptosis rate detected by TUNEL, the mitochondrial transmembrane electric potential after JC-1 staining by flow cytometry, the expression of Bax, Bcl-2 in mitochondrion and Cyt-C, apoptosis inducing factor ( AIF) in cytoplasm by Western blot.ResuIts With the increasing of Dex concentration, the rate of osteoblast apoptosis was significantly increased(F(3,28) =159.0,P=0.000), the positive cell rate of JC-1 stainning was significantly increased(F(3,28) =499.5,P=0.000), the expression of Bax(F(3,28) =17.4,P=0.000)in mitochondrion and Cyt-C(F(3,28) =22.4,P=0.000), AIF(F(3,28) =42.61,P=0.000)in cytoplasm were significantly increased.There were statistically significant difference of above indexes between control group and each experimental group(P<0.05).But there were no significant differences of Bcl-2 in mitochondrion among five groups(F(3,28) =0.62,P=0.607).ConcIusion Dexamethasone increases expression of Bax in mitochondrion, prompts mitochondrial permeability transition pore ( MPTP ) to be over-openning, induces apoptosis in osteoblast via a mitochondria-mediated pathway.

China ; Hearing Loss, Noise-Induced ; prevention & control ; Hearing Tests ; standards ; Humans ; Noise, Occupational ; adverse effects ; legislation & jurisprudence ; prevention & control ; Occupational Diseases ; prevention & control

Objective:To investigate the hepatitis C virus (HCV) infection in hemodialysis patients.Methods:One hundred and fifty hemodialysis patients were tested for HCV-RNA using a reverse transcription-polymerase chain reaction (RT-PCR) assay and for anti-HCV IgG using an enzyme-linked mmunosorbent assay (ELISA).Result:The positive rate of anti-HCV IgG was 24%.The positive rate of HCV-RNA was 26.7%;the total positive rate of HCV markers was 35.3%.Conclusion:HCV infection rate in hemodialysis patients is higher than that of general population.The first-class risk factors for HCV infection is transfusion of blood,while the cross using of dialyzer and dialysis pipe-line is also one of the risk factors.

Objective To investigate the current status and influencing factors of falls self-efficacy among the stroke elderly patients.Methods Totally 170 elderly stroke patients were investigated using the Modified Falls Efficacy Scale (MFES),and they were tested with Berg Balance Scale (BBS) and Time Up and Go Test (TUGT).Results The average score of falls self-efficacy was 108.There were 50.6％ elderly stroke patients assigned to the group with low falls self-efficacy.Multiple Logistic regression analysis indicated that impairments of balance and mobility,severe stroke-related disability were the independent influencing factors associated with FOF,which could explain 52.0％ of variations.Conclusions Low falls self-efficacy among the stroke elderly patients is a common complaint,nurses and physicians should focus on this problem,interventions combining exercise and education of accidental falls should be taken to improve falls self-efficacy of elderly stroke patients,and prevent falls finally.

Objective To establish a new and convenient assay for whole blood lead concentration. Methods Whole blood sample was digested by nitric acid-perchloric. Under the condition of pH 0.8～1.0, lead concentration was examined by Hydridegeneration Atomic Fluorescence Spectrometry.Results The method had good linearity when lead concentration were between 0 to 600 ?g/L, r =0.999. The within-run CV of the method for high, middle and low lead level were 4.1%, 3.6% and 3.5% respectively. The between-run CV were 4.9%, 4.6% and 4.7% respectively. The recovery rates were 105.4%, 98.5% and 94.8% respectively. The single-blind test result of series standard lead samples provided by Chinese Academy of Preventive Medicine were within the acceptable range. The detecting Limit of this method was 0.3 ng. There was no significant interference from main two-valence positiveion. The sample can be storage at lest for 1 months at 4℃. Samples of 869 children from Tianjin were tested by this method. The mean value was 91.9 ?g/L, median was 83.8 ?g/L, all data were within 23.1～386.3 ?g/L. The result showed out positive skewness distribution.Conclusion This method were sensitive, accurate, precise, quick and low-cost. It was suitable for use in clinical laboratories.

Objective To introduce the anatomic basis and evaluat ion of clinical application of the pudendal-thigh island flaps us ing for vaginal reconstruction. Methods The blood supply and innervation to the skin and fascia of the pudendal-thigh region were studied in 5 female cadavers (with 10 sides). 20 patients who underwent vaginal reconstruction with pudendal-thigh island flaps were followed-up, and all the women were married for more than 3 years. Results There were multiple blood supply in the pudendal-thigh area. The cuta neous arterial vessels come from the posterior labial artery, the external pudendal artery and the anterior cutaneous branches of obturator artery. The posterior labial artery was one of the internal pudendal artery branches, a nd the diameter of it was 0.9～1.7 mm (1.3mm in average) in its original site, w hich was 22～35 mm (26mm in average) from the perineal midline. It gave off 4 ～7 branches to the major labia and the pudendal-thigh area while running alon g the lateral site of the major labia accompanying vein and nerve. 20 patients w ho were followed-up satisfied with their perineal appearance and with 10. 2 cm depth of neovagina in average. Twenty neovagina remained supple, and sexually active without difficulty. Conclusions The pedicle of the pudendal-thigh island flaps using for vaginal reconstruction is the post erior labial neurovascular bundle. The flap has reliable blood supply, survive s easily, transfers with partial sensation and few complications. This tech nique introduces a modified approch of vaginal reconstruction using bilateral pudendal- thigh island flaps with satisfactory cosmetic and functional resu lts.

Objective To report the anatomy and clinical application of the marginal mandibular flap pedicled with facial artery in nose reconstruction. Methods Based on the anatomical study of facial artery, the reversed marginal mandibular island flap pedicled with facial artery was designed, and the nasal reconstruction with the flap was operated in 20 cases. Results In 20 cases, the maximal size of flap was 7.0 cm?6.5 cm, and the minimal size was 6.0 cm?4.5 cm, and except the distal part necrosis in one flap, and wound dehiscence in nasal collumella in another flap, all other flaps survived. Followed up for 3 months to 2 years, all reconstructed noses showed satisfactory shapes. Conclusion The method is a new design technique for nose reconstruction with ideal nose appearance, and worth to be recommended.

Objective To introduce a method of repairing the secondary vermilion defect caused by bilateral cleft lip. Methods The two side vermilion flaps beside the defect were cut along the vermilion boundary, and the lip artery was involved in the flaps. The flap may be extended to lower lip if the defect was much large. Then the two flaps were propelled to repair the defective region. Results This method was used in 15 cases, in which the biggest width of the defect was 1.2 cm, and the smallest was 1.0 cm, with all the flaps survived. The postoperative appearance of the upper lip was satisfactory. Conclusion The lip artery is constant, so the blood supply of the flap is reliable and anatomizing the flap is easy. This is a new method and can be widely used in repairing vermilion defects.

Objective To introduce the clinical application of the expanded scalp flap in the repair of baldness. Methods Based on area and shape of the baldness, two or three expanders were buried under the normal scalp galea around baldness. The scalp was expanded by intermittence injecting 0.9 % sodium chloride solution into expanders for 3 7 weeks, and then the expanded scalp flaps were used for repair of the baldness. Results Thirty expanders were used in twenty cases of patients with baldness, and all cases were satisfactory except two cases, in which the expanders exposed. Conclusion The treatment on baldness with expanded scalp flap is reliable. The donor site does not need graft skin. The scalp expansion may be the first choice in the repair of baldness.

Objective To investigate the method of repairing moderate or severe full defect of eyelid. Methods According to eyelid structure and the defect size, the two composite eyelid flaps were designed beside defect based on the arterial arch of the palpebral margins. If the defective area was too large, the lateral composite flap may be extended to lower or upper eyelid at the outer canthus, then the two flaps were propelled to the defective region to repair it. Results Eleven patients had been cured with this method since 1998. The largest length of eyelid defect was 1.7cm, and the smallest was 0.8cm. All defects exceeded 1/3 length of the upper or lower eyelid. All composite flaps survived completely without any complication. The appearance of the repaired eyelid was satisfactory. Conclusion Using the composite flap to repair the full moderate or severe full defect of eyelid is a new and effective method. It can not only provide enough tissues to repair large full defect of the upper or lower eyelid and to restore normal anatomical structure and appearance of the eyelid, but also is easy to be operated without severe secondary deformities, and the blood supply of the composite flap is reliable. The method is worth employing routinely.