Objective To explore the causes and treatment of gastrointestinal complications after anterior approach for thoracolumbar fracture and dislocation.Methods A retrospective analysis was carried out in 153 cases with thoracolumbar fracture and dislocation undergone anterior approach from Jan- uary 1999 to October 2003.Postoperative gastrointestinal complication was seen in 15 cases including sev- en with dynamic intestinal obstructions,three with stress ulcer,three with intestinal bacteria imbalance, one with tuberculosis peritonitis resulted from dissemination of primary tuberculosis,and one with acute relapse of chronic appendicitis.Results All patients were effectively cured by using corresponding methods in regard of different causes.Conclusions(1)Gastrointestinal complications following ante- rior approach for thoracolumbar fracture and dislocation are mainly resulted from following causes,ie,se- rious primary trauma,primary gastrointestinal vegetative nerve injury or that caused by surgical operation, intraoperative contusions of abdominal viscera,postoperative retroperitoneal hematoma,acute lesion of gastric mucous membrane as well as imbalance of intestinal flora.(2)Correct treatment of primary trau- ma,meticulous operation,reasonable utility of antibiotics and appropriate management can effectively prevent and control gastrointestinal complications.

Animals ; Cell Line, Tumor ; Female ; Humans ; Mammary Neoplasms, Experimental ; diagnosis ; metabolism ; pathology ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Organometallic Compounds ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Radioisotopes ; Radiopharmaceuticals ; pharmacology ; Random Allocation ; Rhenium ; Tumor Burden ; drug effects ; bcl-2-Associated X Protein ; metabolism

Objective To study the possible relationships between expression of matrix metalloproteinase(MMP)2,9 and the pathogenesis of preeclampsia in which trophoblast invasion is impaired. Methods MMP-2,9 expression were detected by immunohistochemistry streptavidin-biotin complex (SABC)method in 20 normal term placentae and 20 preeclampsia placentae,respectively.In addition, mRNAs for MMP-2,9 were analyzed by real time PCR in both groups.Results The intensities of both MMP-2 and MMP-9 immunostaining in preeclampsia placentae were significantly declined compared to those of normal term placentae(P

Objective To test the hypothesis that homocysteine can decrease MMP-2 and MMP-9 expression in cultured trophoblasts of early pregnancy and that homocysteine can prevent trophoblasts invasion in the early stage of preeclampsia.Methods Cytotrophoblasts from early pregnancy were isolated and cultured.Trophoblasts were treated with or without Hcy(1 mmol/L)for 48 hour,and real time RT-PCR and gelatin zymography were used to quantify the mRNA and protease activity of MMP-2,-9.Results Treatment with Hcy(1 mmol/L)induced a decrease in MMP-2 mRNA by 21% and MMP-9 mRNA by 11%.At protein level MMP-2 expression decreased 14% and MMP-9 expression decreased 52% compared with control.Conclusions Homocysteine can decrease MMP-2,-9 expression in trophoblasts of early pregnancy and influence its invasion process.

OBJECTIVETo study a new method of the vascularized plantaris tendon transferring.

METHODSThe vascularized plantaris tendon was elevated with the pedicle of the fascial perforating vessel or a small segment of the posterior tibial artery, which was transplanted to the wrist to repair the tendon defects of the flexor pollicis longus or the flexor digitorum muscle resulted from electric injury. According to the defects, the plantaris tendon can be used together with the skin, fascia, or both as a composite flap. 7 cases received the operation with complete survival of the flap.

RESULTSPostoperative follow-up showed satisfactory results in the 7 cases. Through physical exercises, the patients obtained increased joint motion and better function of the hand.

CONCLUSIONThe vascularized plantaris tendon has many advantages, including easy to harvest, easy to plerosis the donor site, little affect to a main vessel, able to repair the complex defects. This method has great potential for applications.

Electric Injuries ; surgery ; Fascia ; Foot ; Hand Injuries ; surgery ; Humans ; Surgical Flaps ; blood supply ; transplantation ; Tendons ; blood supply ; transplantation ; Tibial Arteries ; Transplants ; Wrist Injuries ; etiology ; surgery

Objective To observe the effect of early rehabilitation therapy on recovery from reoperation for recurrent lumbar disc herniation (RLDH).Methods Sixty-five cases who received surgery for RLDH between 2007 and 2009 were randomly divided into a rehabilitation group and control group.Both groups were treated with the same surgical approach and routine treatment.Early and comprehensive rehabilitation therapy was provided in the rehabilitation group during the perioperative period,including preoperative and postoperative muscle strength training,postoperative sitting and standing balance training,and acupuncture.The control group was instructed only in general exercise.Before the operation and 2 weeks and 3,6,12 and 24 months afterward,the surgical outcomes of all cases were assessed using the JOA score and the improvement rate in the JOA score.Any postoperative complications and intervertebral fusion were also observed.Results The average postoperative JOA scores of both groups were significantly higher than their preoperative scores.At all of the time points after the operation,the average JOA scores and all improvement rates in the rehabilitation group were significantly higher than those in the control group.Postoperative complications such as deep venous thrombosis,urinary retention and constipation were significantly less among the rehabilitation group than among the controls.All the intervertebral bone implants were well fused on time.Conclusion Early rehabilitation can significantly improve the effectiveness of RLDH reoperation and reduce the incidence of postoperative complications.It is recommended for clinical application.

Fragile X syndrome (FXS) is one of the most prevalent mental retardations. It is mainly caused by the loss of fragile X mental retardation protein (FMRP). FMRP is an RNA binding protein and can regulate the translation of its binding RNA, thus regulate several signaling pathways. Many FXS patients show high susceptibility to epilepsy. Epilepsy is a chronic neurological disorder which is characterized by the recurrent appearance of spontaneous seizures due to neuronal hyperactivity in the brain. Both the abnormal activation of several signaling pathway and morphological abnormality that are caused by the loss of FMRP can lead to a high susceptibility to epilepsy. Combining with the research progresses on both FXS and epilepsy, we outlined the possible mechanisms of high susceptibility to epilepsy in FXS and tried to give a prospect on the future research on the mechanism of epilepsy that happened in other mental retardations.
Brain ; physiopathology ; Epilepsy ; etiology ; genetics ; pathology ; Fragile X Mental Retardation Protein ; genetics ; metabolism ; Fragile X Syndrome ; complications ; genetics ; Humans ; RNA-Binding Proteins ; metabolism

Objective To evaluate the efficacy of nalmefene antagonizing postoperative respiratory depression induced by opioids.Methods Two hundred and forty ASA Ⅰ orⅡpatients aged 18-64 yr with body weight fluctuating within 20% of the standard body weight were included in this multicenter,randomized,double-blind,positive drug-controlled study.Anesthesia was induced with etomidate 0.3 mg/kg and TCI of sufentanil(effect-site concentration 0.4.ng/ml).Tracheal intubation was facilitated with vecuronium 0.1 mg/kg or rocuronium 0.6mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.Anesthesia was maintained with sevoflurane+ sufentanil TCI(Ce=0.1-0.4 ng/ml).Patients undergoing neurosurgery and liver or kidney operation were excluded.The operation time was within 3 h.The residual effects of muscle relaxants were reversed after operation.The patients were randomly divided into 2 groups(n=120 each):group Ⅰneloxone andgroup Ⅱ nalmefene.Naloxone 0.1 mg or nalmefene 0.25 μg/kg was injected iv over 30 s and was repeated 5 min later if necessary until the respiratory rate＞10 bpm,PETCO2＜45 mm Hg and apnea time＜15 s.The total amount of naloxone was≤0.4 mg while that of nalmefene≤1 μg/kg.BP,HR,SpO2,PETCO2,respiratory rate and apnea time were recorded immediately before and at 2 and 5 min after haloxone/nalmefene administration and then every 5 min until 5 min after extubation.The recovery of spontaneous breathing within 30 min after naloxone/nalmefene administration,extubation time and Ramsay sedation score at 5 min after extubation were recorded.The patients were also observed for adverse reactions.Results Spontaneous breathing recovered within 30 min after naloxone/nalmefene administration in all patients in both groups.The extubation time was significantly shorter in nalmefene group than in naloxone group.There was no significant difference in Ramsay sedation score,BP,HR,SpO2 and incidence of adverse reactions between the 2 groups.Conclusion Nalmefene is better than naloxone in antagonizing opioid-induced postoperative respiratory depression.

Objective To explore the role of Na~+/H~+ exchanger 1(NHE1) in injury of human renal tubular cells(HK-2) induced by postasphyxial-serum of neonates.Methods HK-2 was used as the target cell.The attacking concentration of postasphyxial-serum of neonates was 200 mL/L.First,the experiment was designed as control group and asphyxia group,the expression of NHE1 in the HK-2 was detected by immunohisto chemical method in the cells.Second,the experiment group was designed as control group,asphyxia group,and pretreatment with 5-N-Ethyl-N-isopropylamiloride(EIPA) group,then the change of morphology was observed under inverted microscope,and the cell viability was measured by methyl thiazolyl tetrazolium(MTT) method,and the leakage rate of lactate dehydrogenase(LDH) was determined by biochemical methods.Results Compared with blank control group,the expression of NHE1 in the HK-2 was increased signi-ficantly in asphyxia group,the changes of morphology of HK-2 was most serious and obvious,the cell viability decreased,and the leakage rate of LDH increased significantly in asphyxia group.But compared with asphyxia group,the change of morphology of HK-2 was greatly improved,the cell injury was decreased obviously,the leakage rate of LDH was increased and viability was decreased in pretreatment group in a dose 2 ?mol/L.Conclusions The postasphyxial-serum may induce the expression of NHE1,which plays an important role in injury of renal tubular cell induced by postasphyxial-serum in neonates,and inhibiting activity of NHE1 may relieve the injury of renal tubular cells induced by postasphyxial-serum in neonates.

Objective To explore the effect of erythropoietin(EPO) on apoptosis of human renal tubular(HK-2) cells induced by postasphyxial-serum of neonates.Methods HK-2 cells were used as target cells.The experiment was divided into 4 groups,control group(n=8):HK-2 cells were maintained in standard medium;asphyxia group(n=8):HK-2 cells were treated with serum obtained from neonates with asphyxia.Each culture medium replaced with 200 mL/L suffocation DMEM/F12 serum culture medium;EPO pretreatment group(n=8):HK-2 cells were pretreated 24 h with serum contains 5?104 IU/L EPO,and then deal as asphyxia group;EPO and 5-hydroxydecanoic acid sodium salt(5-HD) pretreatment group(n=8): HK-2 cells were pretreated 24 h with serum contains 5?104 IU/L EPO and 500 ?mol/L 5-HD,and then deal as asphyxia group.All cells were cultured at 37 ℃ in humidified atmosphere with 50 mL/L CO2 for 24 h.The apoptosis rate of HK-2 cells was detected by flow cytometer.The expressions of Caspase-3 and X-linked inlnibitor of apoptosis protein(XIAP) of HK-2 cells were detected by using immunohistochemical method.Results Compared with control group,after stimulated with postasphyxial-serum,the apoptosis rate and the expression of Caspase-3 of HK-2 cells were significantly increased(Pa