Objective To explore the change of degrade of clonazepam in serum with single and repeated - dose administration in children with seizure, and find a reasonable method for using the clonazepam. Methods Children with seizures were divided into single - dose paradigam, repeated - dose paradigam, and decreased - dose paradigam. The concentration of CZP in serum was determined by high performance liquid chromatography( HPLC). Results The serum concentrations of clanazepain in single - dose paradigam were (101.9?12.1),(76.9 ? 5.8),(50.7?2.9),(30.9?5.4),(21.5?6.8)?g/L,the time point that the blood samples collected were 15,30,60,120 and 480 min. The serum concentrations in repeated - dose paradigam were (97. 2 ? 6. 1),(130.4? 13. 4), (99. 4 ? 9.8),(79.6?2.4)?g/L,in decreased-dose paradigam were( 101.1 ?13.1),(123.1 ?6. 6), (99.4 ?9. 8), (79. 3 ? 2. 2)?g/L,in these two groups,the time point were 15,45,60 and 120 min. Conclusion Repeated administration of CZP with decreased dose may increase its effectiveness in treatment without substantially increasing toxicity.

Acute Disease ; Adolescent ; Adult ; Aged ; Child ; Female ; HLA-G Antigens ; metabolism ; Humans ; Interleukin-10 ; metabolism ; Leukemia ; metabolism ; Male ; Middle Aged ; Young Adult

BACKGROUND: To summarize the progress of tissue engineering in repairing spinal cord injury in recent years.DATA SOURCES: A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) and CNKI database (www.cnki.net/index.htm) was performed for articles published between September 1999 and September 2009 with the key words of "spinal cord injury, tissue engineering" in English and Chinese, respectively. Articles published recently or in authoritative journals in the same field were selected.DATA SELECTION: Inclusion criteria: clinical or experimental study about tissue engineering in repairing spinal cord injury.Repetitive studies were excluded. A total of 29 articles were included.MAIN OUTCOME MEASURES: Seed cell selection of tissue engineering; requirements of scaffold materials of tissue-engineered spinal cord, neurotrophic factor for regeneration, special internal environment construction for regeneration.RESULTS: Seed cells of tissue-engineered spinal cord include Schwann cells, olfactory ensheathing cells, embryonic stem cells, neural stem cells and bone marrow stromal stem cells. Scaffold materials involve synthetic or modified natural materials, such as polyglycolic acid, polylactic acid, and lactic acid/glycolic acid copolymer, which benefit cell attachment and nutrition factor aggregation following surface modification. Antibodies that promote or inhibit nerve growth factor in combination with polyoxyl are coupled to function as tissue-engineered scaffold, which may be approaches to repair spinal cord injury by tissue engineering in combination with stem cell transplantation and electric field/magnetic field stimulation.CONCLUSION: The optimal elements for tissue engineering are the key role in repairing spinal cord injury by tissue engineering.

Objective To investigate the difference of curative effects between the complete video assisted thoracic surgery (C-VATS)and traditional open surgery in the treatment of elderly patients with lung cancer,and to clarify the specially curative effect of C-VATS.Methods 80 patients with lung cancer without diabetes mellitus,chronic brouchitis and heart diseases aged over 65 years were enrolled in the study.They were divided into C-VATS group and open surgery for lobectomy (OPEN)group (n=40)according their wishes.The operation time,number of lymph nodes removed,amount of intraoperative blood loss,postoperative thoracic drainage,chest tube duration, postoperative hospitalized time, postoperative pain degree, incidence of postoperative complications, preoperative and postoperative sedentary heart rate (HR)of the patients in two groups were compared.Results The operation time in C-VATS group(193.12 min±59.06 min)was longer than that in OPEN group(167.17 min±54.01 min) (P<0.05),and the number of lymph nodes removed in C-VATS group(14.6±7.5)had no significant difference compared with OPEN group(15.2 ± 4.5)(P>0.05).The postoperative pain degree in C-VATS group(2.54 ± 0.12)was lower than that in OPEN group(4.61 ± 0.10)(P<0.05);the postoperative chest rube duration in C-VAS group(6.14 d ± 3.32 d)was short than that in OPEN group (11.67 d ± 4.13 d);the postperative hospitalized time in C-AVA group(8.52 d±3.25 d)was shorter than that in OPEN group (14.76 d±6.11 d)(P<0.05).There were no significant differences of intraoperative blood loss(231.28 mL±203.15 mL vs 213.33 mL± 187.18 mL),postoperative thoracic draginage(1 597.83 mL± 1 049.29 mL vs 1 690.68 mL± 1 043.37 mL), incidence of postoperative complications between C-VATS group and OPEN group(P>0.05).The postoperative sedentary HR in C-VATS group and OPEN group were significantly higher than preoperative;the postoperative sedentary HR recovered to the preoperative level 3 d after operation in C-VATS group and it recovered to the preoperative level 7 d after operation in OPEN group. Conclusion Compared with traditional open thoracic surgery, C-VATS owns the characteristics such as less trauma, less pain, less hospital stay and better postoperative recovery in the aged patients with lung cancer.

Objective To study MRI findings of pancreatic ducts of piglets with chronic pancreatitis (CP) induced by pancreatic duct ligation and analyze the relationship between pancreatic duct changes in piglets with CP and the pathological severity of CP. Methods Thirty healthy piglets were included in this study. Five piglets were randomly selected as normal control group, and the remaining 25 piglets were served as the experimental group. The duct ligation operations were performed on experimental group. After 2 to 18 weeks, pancreas and pancreatic ducts were observed on MRI. Then the pancreas was removed and graded into three types by histopathology. The relationship between the diameter of pancreatic duct or the pancreatic branch displaying rate and the severity of CP was analyzed by Spearman correlation coefficient. Results CP was found in 21 piglets( 84. 0% ) in the experimental group including mild ( n = 7 ), moderate ( n = 8 ) and severe( n = 6) pancreatitis. Pancreatic ducts were shown in mild CP and the edge of pancreatic ducts was irregular in three cases. The dilated RPD, LPD and MPD constituted the "person" form in moderate and severe CP. The diameter of pancreatic ducts was(0. 9 ±0. 3)mm, (2. 9 ± 1.4)mm and (4. 8 ± 1.2)mm in mild, moderate, and severe CP respectively. The expansion extent of pancreatic ducts was correlated with the severity of CP of piglets (r = 0. 837, P ＜ 0. 05). The pancreatic branch displaying rate increased with the increase of the severity of CP ( r = 0. 990, P ＜ 0. 05 ); the displaying rate was 0/7 for mild, 3/8 for moderate, and 5/6 for severe CP. Conclusions The dilated pancreatic ducts with "person" form in piglets with obstructive CP created by pancreatic duct ligation. The pancreatic duct changes on MRI reflect the severity of CP of piglets.

Adult ; Diagnosis, Differential ; Female ; Humans ; Keratin-18 ; metabolism ; Mucin-1 ; metabolism ; Omentum ; metabolism ; pathology ; Peritoneal Neoplasms ; metabolism ; pathology ; ultrastructure ; Pregnancy ; Trophoblastic Neoplasms ; metabolism ; pathology ; ultrastructure ; Trophoblastic Tumor, Placental Site ; pathology ; Vimentin ; metabolism

Objective To study postoperative delirium in elderly patients.Methods We investigate the morbidity of postoperative delirium in 142 elderly patients (≥ 60 years)after gastrointestinal surgery by using Confusion Assessment Method (CAM) and Delirium Rating Scale Revised-98 (DRS-R98) scores.Data were analyzed using Student's t test and Chi-squaretest respectively with SPSS 19.0.Results Of 142 patients,delirium was diagnosed in 36 patients(25.4％),delirium developed in 4,7,17,7,1 patients in posto perative 1,2,3,4-7,7 + days respectively.There were significant difference in hospital stay:17.7 ± 2.6 days (postoperative delirium) and 13.4 ± 2.3 days (no postoperative delirium),t =4.608,P =0.000 1.The postoperative complications (52.8％ / 23.6％,x2 =10.710,P =0.001) and ICU admission (22.2％/6.6％,x2 =6.939,P =0.008) significantly increased.Conclusions Postoperative delirium is recognized as one of the most common surgical complications in elderly patients with gastrointestinal surgery leading to other major postoperative complications,and prolonged hospitalization.

Objective:To investigate the expression of TIP30 and its relationship with clinico-pathological characteristics in patients with extrahepatic cholangiocarcinoma (ECC).Methods:The expression of TIP30 in 78 cases of ECC tissues and 78 cases of para-cancerous tissues were detected by immunohistochemistry.Results:The positive expression rate of TIP30 was 43.59％ and 75.64％ in ECC tissues and para-cancerous tissues,respectively.Differences were statistically significant (P＜ 0.05).The expression levels of TIP30 were not correlated with age,gender,degree of differentiation and tumor size(P＞0.05),but correlated with lymph node metastasis,distant metastasis and TNM staging(P＜ 0.05).The median overall survival of 78 ECC cases was 14.8 months,and it of TIP30 positive expression cases was 20.3 months,statistically higher than 11.5 months in TIP30 negative expression cases(P＜ 0.01).Conclusion:The downregulation of TIP30 is closely correlated with the development,metastasis and prognosis of ECC.TIP30 may be used as a molecular marker to identify and predict the progression,metastasis and prognosis of ECC.

Objective This study is about to detect the KCNJ5 gene variations in aldosterone-producing adenoma (APA) with primary hyperaldosteronism (PA),and to investigate the association of the KCNJ5 gene missense mutations with APA and PA.Methods A total of 46 APA tumors and their clinical characteristics were collected from Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region,and all the tumors were confirmed by pathology.All the samples of the coding region segments of KCNJ5 were detected by PCR and direct DNA sequencing to compare the different missense mutations in the tumor cells and peripheral blood cells and to analyze the association between the genotype and phenotype.Results Three missense mutations were found in 46 patients with APA:c.451G ＞ C/A (p.G151R) (5/46),c.503T ＞ G (p.L168R) (4/46),c.830T ＞ A (p.S209T) (12/46).S209T,as an unreported somatic mutation was observed.There were no missense mutations detected in the peripheral blood.Sex,age,systolic blood pressure,diastolic blood pressure,duration of hypertension,plasma potassium,urine potassium,aldosterone,plasma renin activity,aldosterone,and plasma renin activity ratio,as well as the rate of positive family history were compared between the mutants and wild-types.Systolic blood pressure and plasma potassium level among G151 R,L168R,and S209T had statistical differences.Systolic blood pressure in G151R was significantly higher than the other two groups,while the plasma potassium level was significantly lower than the other groups.Conclusions Three missense mutations were found in 46 patients with APA.The subjects with mutations had more serious condition than those without mutations after comparing their clinical phenotype.Besides,other different subtypes may exist in PA.

OBJECTIVETo explore the effective method of preventing cubitus varus deformity in nonoperative treatment of humeral supracondylar fracture in children.

METHODSFrom May 1992 to December 2013,319 patients with hemeral supracondylar fracture in children were treated with manual reduction and external plaster fixation in extension position. There were 253 males and 66 females, aged from 15 months to 13 years old with an average of 6.7 years. Among the patients with humeral supracondylar fracture, extension type was in 284 cases and inflexion type was in 35 cases; 167 cases on the left and 152 cases on the right. Injury to treatment time was 1 hour to 7 days with a mean of 1.8 days. No included nerve injury and operative case in the patients.

RESULTSAll patients were followed up from 3 months to 14 years with an average of 37.3 months. All fractures obtained bone healing and healed time was 6 to 8 weeks with an average of 6.9 weeks. No complications of serious cubitus varus deformity,vascular nerve injury or volkmann contracture were found. In 183 cases, the carrying angle was consistent with itself contralateral,ranged from 5° to 15°; in 105 cases, the carrying angle of uninjuryed side was decreased. During the reset, the carrying angle of 26 patients with ulnar deviation angle was for -5° to 0°; and 5 patients with radial deviation angle was for 15° to 18°, basically does not affect the appearance. The activities of all elbow joint were normal.

CONCLUSIONExternal plaster fixation in extension position has some value to preventing cubitus varus deformity in nonoperative treatment of humeral supracondylar fracture in children and hope that more scholars to do further study.

Adolescent ; Casts, Surgical ; Child ; Child, Preschool ; Female ; Fracture Fixation ; methods ; Humans ; Humeral Fractures ; surgery ; Infant ; Male