Objective To investigate the relationship between the type of gliding contusion and its mechanism with site of force.Methods The site undergoing contusion and ways of force are respectively determined by skull anatomy location and details of these cases.Then,the 132 specimens of brain,which have been fixed by formalin,are sliced in coronal section and sagittal section and stained with HE,observed under microscope.ResultsGliding brain contusion could appeared at the top and bottom region of brain respectively.Top-injury type,were observed in 65 cases(49.24%),base-injury type,were found in 38 cases(28.78%).There were 29 cases(21.96%) in which contusion could be found at both top and base of brain,we called mixed type.We found that the injury area depend on the ways of force-act:the top-injury type mostly caused by the force on cupular part of pars zygomatica in acceleration,the base-injury type mainly caused by the force on occipitalia in deceleration and the mixed type caused by the force on the boundry of the calvaria and occipital in deceleration.Conclusion The type of gliding contusion is relevant with mechanism and site of force.

Objective To explore the clinical significance of platelet count, C-reaction protein and D-dimer in Kawasaki disease children with coronary artery lesion. Methods 54 cases of children with KD treated in our hospital from January 2013 to December 2015 were divided into coronary artery injury (CAL) group (n=15) and without coronary artery injury (NCAL) group (n=39), according to the cardiac ultrasound examination. The relationship between the changes of platelet count, C reactive protein and D- two and coronary artery lesion in the 2 groups of acute and convalescent stages were detected. Platelet count, C-reaction protein and D-dimer of 54 healthy children were measured as a control. Results The levels of the platelet count, C-reaction protein and D-dimer of the KD children during acute stage are significantly higher than the control group (P<0.05), while the levels of C-reaction protein and D-dimer of the KD children during recovery stage was significantly decreased after treatment (P<0.05), the platelet count is remarkably increased (P<0.01). The platelet count, C-reaction protein and D-dimer for the KD children with coronary artery malformation, either at acute stage or recovery stage, compared with the control group were significantly different (P<0.05), with statistical significance. Conclusion The changes of the platelet count, C-reaction protein and D-dimer levels have close relations with the cardiovascular damage to the KD children.

0.05). Conclusion Brachytherapy ,when used to increase the dose effect,may enhance the local effect without any change in the overall survival.

Objective To investigate clinical efficacy of simultaneous integrate boost for glioblastoma with intensity?modulated radiotherapy ( SIB?IMRT). Methods A total of 46 patients with glioblastoma who underwents SIB?IMRT from January 2013 to August 2014,were retrospectively analyzed. Toxicity after completion of SIB?IMRT were assessed. Kaplan?Meier method was used to analyze survival and progression?free survival. Multivariate analyses were performed to determine significant prognostic factors. Results There was no patients delayed by more than grade 3 radiation toxicity. The median overall survival and 1?year survival rates was 69 weeks and 73%,respectively. The progression free survival and 1?year progression?free survival rate were 43 weeks and 39%,respectively. The pattern of failure was identical (9 Local, 7 distant and 0 marginal recurrence). Multivariate analyses show that temozolomide concurrent chemoradiotherapy were independent factors correlated to prognosis. Conclusions The preliminary results demonstrate that SIB?IMRT for glioblastoma appear to be effective and safe. With the limted number of patients in this group,SIB?IMRT could be used for treating glioblastoma with caution,which deserves further study.

Objective To establish C6 glioma model in rat brain and to study its biological behavior(such as the incidence of tumor development, the process of cell invasion pathological characteristics of C6 and neoangiogenesis, the spontaneous regression of experimental gliomas and the best experimental time window).Methods C6 tumor cells and DMEM were implanted into the right caudate of 50 male Wistar rats. 9 rats implanted DMEM is the control group. The animals were examined by MRI and pathological staining at postoperative day (POD) 3, 7, 14, 21,28, 35, and 50. Matrix metalloproteinases-2 (MMP-2) and CD31 immunohistochemistry staining were used to study the histopathological features of the developed tumor. Methodology, physical findings and biological behavior were also discussed. Results 45 Wistar rats survived after surgery and tolerated MRI procedures well. On POD 7, there was a focal signal at the implantation site. The C6 cells sprout to the surroundings along the nerve fiber. During the day 14～28, the tumor exhibited a marked increase in size with focal mass effect, and immunohistochemical-staining shows MMP-2 and CD31 is overexpression; C6 cells were aggregated and blood brain barrier were destroyed greatly. Most of the tumor bearing rats died within 30 days. But, C6 cells in the two rats retrogress spontaneously after more leucocytes rounded 28 days. HE staining shows tumors.Conclusion The characteristics of rat C6 brain tumor model mimicked the human tumor with respect to its development, progression, and invasion. Although, part of C6 tumor spontaneously regressed, it is a useful animal model of glioblastoma for pre-clinical evaluation of various therapeutic strategies for the management of glioblastoma. The best experimental time window is 14 to 28 days.

BACKGROUND:Present studies mainly focused on in vitro culture of bone marrow mesenchymal stem cells(BMSCs)and cell transplantation for treating intracalvarium diseases.However,the understanding of survival,differentiation,migration and structure of transplanted cells in the damaged spinal cord is limited.OBJECTIVE:To explore effects of local BMSC transplantation in repair of spinal cord damage and feasibility of replacement therapy of BMSCs.METHODS:Adult healthy female Sprague-Dawley rats were randomly assigned to cell transplantation and control groups.Rat models of spinal cord transection damage were established.Rat BMSC suspension or calcium and magnesium phosphate buffer were transplanted immediately after injury to the damage zone.At 1 day,1,2,3,4 and 8 weeks before and after transplantation,BBB score motor function was observed in rats,and at 1 week after transplantation,immunohistochemical staining was utilized to observe BrdU-labeled BMSC survival in the spinal cord damaged site.At 4 weeks after transplantation,the general observation and histological detection were observed.RESULTS AND CONCLUSION:At 1-8 weeks after transplantation,BBB scores were higher in the cell transplantation group than in the control group.At 1 week following surgery,immunohistochemical staining showed that BrdU-positive cells were detected in the distal end of rat spinal cord in the cell transplantation group.At 4 weeks following surgery,nerve fibers were found in the damaged spinal cord.These verified that BMSCs were transplanted into rat damaged spinal cord immediately following damage,and the transplanted cells could survive.Living BMSCs can differentiate into neurons,and formed neuron pathway in the local region of damage,which will promote the recovery of conduction function of spinal nerve fibers,and contribute to the recovery of rat hindlimb motor function following high-level spinal cord injury.

Objective To study the clinical distribution and detection of the efflux pump gene in multiple drug-re?sistant acinetobacter baumannii. Methods The clinical distribution of 96 strains of multiple drug-resistant acinetobacter baumannii was analyzed. K-B method was used to detect 96 strains of multi resistant bauman resisted to 15 kinds of antibiot?ics. PCR amplification was used to detect the efflux pump gene. Results Ninety-six strains of multiple drug-resistant aci?netobacter baumannii mainly distributed in intensive care unit (ICU, 54.2%) and respiratory department (18.8%). The drug resistance rates to quinolone, cephalosporins, amino glucoside, tetracycline were above 70%. The 52 strains of multiple drug-resistant acinetobacter baumannii detected in ICU included 18 strains of adeB (34.62%), 16 strains of adeR (30.77%), 18 strains of adeS (34.62%), 18 strains of adeJ (34.62%), 0 strain of adeE and18 strains of adeM (34.62%). The18 strains of multiple drug-resistant acinetobacter baumannii detected in respiratory department included 9 strains of adeB, 8 strains of adeR, 8 strains of adeS, 8 strains of adeJ, 0 strain of adeE and 8 strains of adeM. Conclusion Efflux pump genes are impor?tant factors for multiple drug-resistant acinetobacter baumannii distributed in ICU and respiratory department.

BACKGROUND: Acidic fibrobiast growth factor can regulate cell proliferation, migration, differentiation and survival, also can down-regulate the known inhibitor of axon regeneration, such as proteoglycan, help axons overcome these inhibitory factors, and have significant role on the regeneration of nerve fibers.OBJECTIVE: To study the feasibility and effect of the acidic fibroblast growth factor combined with peripheral nerve transplantation in the treatment of high-level spinal cord injury in rats.METHODS: A total of adult 108 female SD rats were randomly divided into autologous nerve group, autologous nerve combined .with acidic fibroblast growth factor group, and high-level spinal cord injury group. The rat T_(8-10) spinous process and lamina were bite, revealing dural sac, high-level spinal cord was resected at a horizon level, cutting 3 mm, no nerve fibers were confirmed to be attached under the microscope. In the autogenous nerve group and autologous nerve combined with acidic fibroblast growth factor group, bilateral the 8~(th) to 10~(th) pairs of intercostal nerves were harvested 2 cm, then cross-transplanted into high-level spinal cord defect (proximal white matter and distal gray matter, distal white matter and proximal gray matter), fibrin gel and fibrin gel containing acidic fibroblast growth factor were used respectively to fix the implanted intercostal nerve, followed by dural suture.High-level spinal cord transection group was subjected to exclusion between stumps. At 90 days postoperation, somatosensory evoked potential and motor evoked potential were used to test nerve electrophysiological recovery. At 76 days postoperation,biotinylated dextran amine anterograde tracing was applied to observe the motor conduction bundle recovery. At 60 days postoperation, hindlimb motor function recovery was assessed by BBB score.RESULTS AND CONCLUSION: The somatosensory and motor evoked potential waveforms were not elicited in rats of high-level spinal cord transaction group, but did elicit in autogenous nerve group and autologous nerve combined acidic fibroblast growth factor group. The average latency and amplitude of somatosensory and motor evoked potentials, as well as BBB scores in autologous nerve combined acidic fibrobiast growth factor group were significantly superior to autologous nerve group (P ＜ 0.01).In the autogenous nerve group and autologous nerve combined acidic fibroblast growth factor group, many more biotinylated daxtran amine-positive nerve fibers passed in the damage zone, compared with high-level spinal cord transection group (P ＜0,01), the autologous nerve combined acidic fibrobiast growth factor group was more than autogenous nerve group (P ＜ 0.01). It is indicated that autologous peripheral nerve graft acidic flbroblast growth factor can better restore the limb motor functions of rats after high-level spinal cord injury.

Objective To review the effect of exposed and buried Kirschner wire fixation of lateral humeral condyle fracture in children.Methods Randomized control trials (RCTs) about exposed versus buried Kirschner wire fixation of lateral humeral condyle fracture in children were identified through electronic search using the Cochrane Collaboration search strategies and manual search.Electronic database included Cochrane Library,Medline,PubMed,CBM,VIP,CNKI,Wanfang database and other Chinese and English database.Manual research included related journals and conference proceedings.Quality analysis of the included literatures was performed using the methodological index for non-randomized studies (MINORS).RevMan 5.3 software was used for Meta analysis.Results Four studies involving exposed Kirschner in 150 cases and buried Kirschner in 351 cases were included.The two techniques were similar with respect to postoperative infection (OR =1.10,95％ CI 0.52 ～ 2.33,P ＞ 0.05),superficial infection (OR =1.45,95 ％ CI 0.66 ～ 3.18,P ＞ 0.05),reoperation rate (OR =2.29,95％CI 0.51 ～ 10.25,P ＞0.05),delayed union rate (OR =1.57,95％ CI 0.76 ～ 3.21,P ＞0.05) and total complications (OR =1.57,95％ CI 0.76 ～ 3.21,P ＞ 0.05).However,Kirschner wire exposure shortened the time of pulling out Kirschner wire (MD =-13.28,95％ CI-16.42 ～-10.14,P ＜0.05).Conclusion Applied for lateral humeral condyle fracture in children,exposed versus buried Kirschner wire fixation results in short Kirschner wire stabilization time that avoids local anesthetic and cost while pulling out Kirschner wire in the late stage.

Objective To observe the effect of intermittent inhalation of budesonide on lung function and recurrence in asthmatic infants .Methods 120 children with recurrent wheezing and asthma predictive index were selected.They were randomly divided into control group and observation group according to the digital table ,60 cases in each group .The two groups were given conventional treatment .The observation group was treated with high dose of inhaled budesonide in the acute phase for 7 days,and stopped after the symptoms were controlled .However,cold air or acute infection caused wheezing recurrence ,used the above dose for 7 days to control the wheezing symptoms ,if not properly controlled to extend the treatment time so that wheezing control .In the control group ,children were treated with foggy cans inhalation of fluticasone propionate aerosol .After the symptoms were controlled ,the dose was reduced for 3 months.If the cold air or the occurrence of acute wheezing ,should be treated in time.The time of disappearance of wheeze in the lungs of the two groups was observed .The changes of lung function were observed before and after treatment for 6 months.The number of recurrent respiratory tract infections was observed in the two groups during this period.Results The disappearance time of wheeze ,cough,wheezing rale between the two groups had no statistically significant differences(t =0.67,P =0.25;t =0.96,P =0.17;t =1.60,P =0.06).Before treatment,the lung function indicators between the two groups had no statistically significant differences (all P>0.05).After treatment, TV,VPFE/VE,TPTEF/TE of the two groups were improved (all P<0.05),and there were no statistically significant differences between the two groups (all P>0.05).The number of respiratory infections ,the number of wheezing and the duration of wheezing in the observation group were less than those in the control group (t=14.72,P=0.00;t=9.15,P=0.00;t=6.97,P=0.00).There were 5 cases of hoarseness and 4 cases of rash in the control group .There were no serious adverse reactions in the observation group ,the difference was statistically significant (χ2 =9.73,P=0.002).Conclusion Intermittent inhalation of budesonide suspension can improve the clinical symptoms and improve lung function in children .It is better than long -term inhaled glucocorticoid in prevention of wheezing and with safety.It is suitable for clinical use .