Objective To explore the factors relating to the severity of Guillain-Barr? syndrome (GBS) (i.e. of being the mild form or in need of mechanical ventilation), and to find the predictors in early clinical presentations and laboratory investigations as to guiding the early management of GBS. Methods All 123 cases of patients with GBS admitted to Xuanwu Hospital from 1996-2002 were collected, and divided into two groups based on the international criteria for different severity of GBS. Mildly affected patients (i.e. able to walk unaided during the whole course or the Medical Research Council [MRC] muscle power grading scale≥4 in both lower limbs at nadir) and ventilated patients (i.e. in need of mechanical ventilation) were divided in this study. Characteristics of each group in early clinical presentations and laboratory investigations were analyzed in univariate conditional Logistic model in order to find out the predictors. Results In all 123 patients studied, 32 were having mild GBS; 29 severe GBS (i.e. in need of mechanical ventilation during the course). Men (P=0.047) and patients without bulbar dysfunction (P=0.002) were more likely to become mild GBS. The possibility of being mild form was 3.33∶1 between man and woman, 1∶20.17 between those with and without bulbar dysfunction. Patients with bulbar dysfunction (P

OBJECTIVE:To explore the effect of olmesartan on NT-proBNP and high-sensitive C- reactive protein(hs-CRP) and left atrial diameter (LAD) in elderly hypertensive patients with paroxysmal atrial fibrillation (PAF). METHODS:188 cases of elderly hypertensive patients with PAF from May 2011 to May 2013 were divided into control group(n=94)and observation group (n=94),both groups received the treatment of amiodarone,observation group were additionally given olmesartan on the basis of conventional treatment,the treatment cycle was 12 months in two groups. NT-proBNP,hs-CRP,LAD changes and atri-al fibrillation(AF)recurrence were compared between 2 groups before(T0)and after 1 month(T1),3 months(T2),6 months (T3)and 12 months(T4)treatment;related factors for recurrence of atrial fibrillation were analyzed. RESULTS:NT-proBNP and hs-CRP in observation group were lower than control group at T3-T4,with significant difference(P<0.05);LAD improvement in observation group was better than control group,with significant difference (P<0.05). After treatment,the decent range of NT-proBNP and hs-CRP in observation group were higher than that control group,with significant difference(P<0.05);AF re-currence in observation group were lower than control group at T3-T4,with significant difference(P<0.05);Multiple stepwise re-gression analysis showed that NT-proBNP and hs-CRP were positively related with LAD,with significant difference (P<0.05);multi-factor logistic regression analysis showed that the NT-proBNP level,hs-CRP,LAD were positively correlated with AF re-currence,NT-proBNP drop and hs-CRP drop were negatively correlated with AF recurrence. CONCLUSIONS:Serum NT-proB-NP and hs-CRP levels are closely related to LAD and AF recurrence in elderly hypertensive patients with PAF,and olmesartan can decrease the plasma NT- proBNP CRP levels,reduce inflammation response and improve left atrial remodeling so as to re-duce the AF recurrence.

In order to study mechanical stress on root from orthodontic tooth movement by sliding mechanics, a 3-dimensional finite element model incorporating all layers of a human mandibular dental arch with orthodontic appliance has been developed to simulate mechanical stress on root from the orthodontic tooth movement. Simulated orthodontic force of 2 N at 0, 30 and 45 degree from the horizontal axis was applied to the crown of the teeth. The finite element analysis showed when orthodontic forces were applied to the tooth, the stress was mainly concentrated at the neck of the tooth decreasing uniformly to the apex and crown. The highest stress on the root was 0.621 N/mm(2) for cervical margin of the canine, and 0.114 N/mm(2) for apical region of the canine. The top of canine crown showed the largest amount of displacement (2.417 microm), while the lowest amount of displacement was located at the apical region of canine (0.043 microm). In conclusion, this model might enable one to simulate orthodontic tooth movements clinically. Sliding force at 2 N is ideal to ensure the bodily orthodontic tooth movement. The highest stress concentration in the roots was always localized at the cervical margin when orthodontic force of 2 N at 0, 30 and 45 degree from the horizontal axis, so there may be the same risk of root resorption when orthodontic force of 2 N at 0, 30 and 45 degree was used in clinic cases.
Computer Simulation ; Dental Arch/*physiology ; Finite Element Analysis ; Orthodontic Anchorage Procedures ; Orthodontic Appliances ; Stress, Mechanical ; Tooth Movement ; Tooth Root/*physiology

Objective: To analyze the value and reliability of combined free fibula flap and radial forearm flap in the reconstruction of extensive composite oro-mandibular defects. Methods: Extensive composite oro-mandibular defects were reconstructed in 23 consecutive cases (averagely aged 52.9 years old) with combined free fibula flap and radial forearm flap from March 2000 to January 2002. Data concerning the operation, defect description and site, recipient vessel and complications were reviewed. Results: The overall flap survival rate was 100% (all of 46 flaps) without partial or total flap necrosis. The overall complication rate was 30.4%. The vessel thrombosis rate was 2.2%, and the flap salvage rate was 100%. Conclusion: In selected cases, combined free fibula flap and radial forearm flap method may provide satisfactory reconstruction for extensive oro-mandibular defect, and greatly improve the quality of life of patients.

Objective To investigate the clinical application of free submental flap for defects reconstruction after oral cancer ablation.Methods Eleven cases of free submental flaps for defects reconstruction after oral cancer ablation from April,2013 to May,2014 were reviewed.The primary disease,defect type,flap side,flap size and flap survival rate were recorded.The follow-up data of tumor recurrence,lymph node metastasis,as well as postoperative facial appearance and function of marginal mandibular branch of facial nerve were collected.Results Primary disease of all 11 cases was oral squamous cell carcinoma.No flap failure was reported and the overall flap survived.The follow-up period was 6-18 months with the average of 9 months.There was no tumor recurrence and metastasis of lymph node.Postoperative facial appearance was satisfactory and there was no nerve injury of marginal mandibular branch which showed normal and symmetrical expression motion.Conclusion Free submental flap owns many ad vantages including constant anatomy,long vascular pedicle,wide range of indications and low donor-site morbidity.Contralater submental flap may avoid potential lymph node metastasis.Free submentai flaps is an ideal choice for reconstruction of oral and maxillofacial defects after cancer ablation.

AIM:To investigate the differences of clinical signs and pathological structure of unilateral nasal pterygium and unilateral double pterygium.METHODS:Retrospective study.Totally 11 unilateral nasal pterygium and 11 unilateral double pterygium were collected to observe the size of the tissue area, the classification of blood vessels, the transparency and the break-up time of tear film.The 11 surgically excised double pterygia (11 eyes) and 6 samples of normal conjunctiva were collected for the study.With 40g/L paraformaldehyde fixation, paraffin sections were stained with Haematoxylin-Eosin, to observe the differences with nasal and temporal pathology under light microscope.RESULTS:In unilateral double pterygium, the tear break-up time was significantly shorter than that of unilateral nasal pterygium (t=3.410, P=0.003).In unilateral nasal pterygium, there was a significant negative correlation between tear film break-up time and tissue size(r=-0.927, P<0.01) and transparency(r=-0.764,P<0.01).In unilateral double pterygium, the tear break-up time was significantly negatively correlated with the growth time (r=-0.661, P<0.05), tissue size (r=-0.775, P<0.01) and transparency (r=-0.671,P<0.05).In unilateral double pterygium, compared with the temporal side, the quantity of the layers of corneal epithelial cells (t=-7.351, P<0.05), vessels (t=-7.400, P<0.05) and inflammatory cells (t=-7.481, P<0.05) increased.CONCLUSION:Compared with unilateral nasal pterygium, the tear film break-up time of unilateral double pterygium was poor.In unilateral double pterygium, with high activity, the degree of proliferation of squamous epithelium, hyperplasia and inflammatory reaction are significantly higher than those of the temporal side.

Objective To elucidate the effect of ex vivo expansion of umbilical cord blood (UCB) mononuclear cells (MNCs) on their implantation capability and the hematopoietic reconstitution, and to find a feasible way of applying ex vivo expanded UCB MNCs to clinical transplantation.Methods UCB MNCs were cultured in short-term in serum-free medium with different early acting cytokines combinations in order to observe the amplification result and cells apoptotic difference. The 6-day expanded cells were transplanted into sublethally irradiated NOD/SCID mice to assess the implantation and the hematopoietic reconstitution of the survival mice.Results UCB MNCs reached the best amplification result between day 6 and day 10 with the contribution of SCF, FL, IL-6 and IL-3 in common and the presence of Annxin V on the surface of cells obviously decreased. Six weeks after transplantation, CD45, CD34, CD33, CD3 and CD19 antigen could be detected by FCM on BM, spleen and thymus cells of the alive mice and the human specific Alu and Cart-Ⅰ repetitive sequence could be detected in the DNA obtained from peripheral blood by PCR.Conclusion After 6-day effective expanding with SCF+FL+IL-6+IL-3 UCB MNCs can be implanted into NOD/SCID mice successfully and contribute to reconstitute the multiple hematopoiesis.

Objective To study the perioperative treatment of the patients having fracture with hemophilia A. Methods Seven male hemophilia A patients with fractures were treated in our hospital from Jan. 1988 to Apr. 2003. All the patients received coagulation factor replacement treatment. The plasma level of factor Ⅷ was measured at preoperation, intraoperation and postoperation, fracture was treated by internal fixation, and the mean follow-up period was 16 months. Results In this series there were 1 severe, 2 moderate, 2 mild, and 2 pre-clinic hemophilia A patients, all patients had bone union during the follow-up, and no complications such as hematoma, infection and loosening or breaking of internal fixation happened. Conclusion The surgical treatment of fractures with hemophilia A can obtain excellent clinical outcome throug careful perioperative preparation.

Objective To observe the characteristics of chromatin conformation in hypothalamus and pituitary gland of rats with different ages (16 17 weeks and 100 105 weeks of age). Methods Micrococcal nuclease (MCN) and deoxyribonuclease I ( DNase I) were used as the probe to differentiate chromatin conformation and agarose gel electrophoresis and polyacrylamide gel electrophoresis (PAGE) were employed to investigate the changes of chromatin conformation in rats with different ages. Results Chromatin DNA of hypothalamus and pituitary gland in old rats existed a repeat length (nucleosome core and linker region) of (190?7)bp and (171?8)bp, and in young rats (193?9)bp and (170?5)bp respectively. PAGE showed that DNase I cleaved nucleosome DNA at 10 bp intervals and the cleavage patterns were the same in all ages of rats; comparison of DNA fragments digested by DNase I in young and old rats showed that less fragments with lower base pair were produced in old rats. Conclusions (1) No aging related changes were observed with the repeat length of chromatin nucleosome DNA in hypothalamus and pituitory gland, but there was difference depending on tissues. (2) The chromatin DNA mainly existed in B type of duplex conformation and contained similar super helical structure of solenoid in hypothalamus. (3) Further experiments showed that the chromatin DNA in hypothalamus and pituitary gland from elderly rats was more resistent to DNase I digestion.

Objective To detect the pain condition in patients with Parkinson's disease(PD) and explore the clinical significance.Methods From May 2007 to February 2008,pain was examined in 162 PD patients in Department of Neurology,West China Hospital,Sichuan University and in 135 healthy controls well matched for gender,age and education.Statistics analysis was employed according to gender,age,the form of morbility,early-onset PD or late-onset PD,duration and Hoehn-Yahr degree.Results The incidence of pain in PD patients(53.1%)was higher than that in the healthy controls(23.7%)(P