Cytokine-Induced Killer Cells ; immunology ; Cytotoxicity, Immunologic ; Dendritic Cells ; immunology ; Fetal Blood ; immunology ; HL-60 Cells ; Humans ; K562 Cells ; Killer Cells, Natural ; immunology

Objective To study the causes of rehematomas after operations of traumatic hematomas of perisylvian area.Methods The causes of 50 cases of rehematoma after operation were analyzed retrospectively.Results The big hematoma in primary contusion and laceration of brain happened in 19 cases(38%),delayed epidural hematoma in opposite side in 15 cases(30%),increased intracerebral hematoma in 9 cases(18%),epidural hematoma in primary area in 3 cases(6%),subdural hematoma caused by postoperative lumbaropuncture in 3 cases(6%),hematoma in encephalonecrosis in 1 case(2%).Conclusion Insuitable operation and hemostasis are the main causes of rehemorrhage,and fracture line in the opposite side,and thrombocytopenia are high risk factors of rehematoma.

BACKGROUND:Compared with the fixation of bone cement prosthesis,the fixation of cementless femoral prosthesis does not have the folowing worries,including cement-prosthesis separation,cement sheath rupture,and cement debris-induced osteolysis.Long-term outcomes are good,and the survival rate is high.OBJECTIVE: To observe the preliminary clinical results and complications of total hip arthroplasty with Accolade TMZF cementless femoral stem.METHODS:From February 2010 to July 2012,67 patients (70 hips) underwent primary total hip arthroplasty with cementless femoral stem.Al patients were treated with Accolade TMZF Biological hip prosthesis system.Femoral component was treated with the same Accolade TMZF cementless femoral stem.Acetabular component was treated with Secure-fit HA and Trident PSL HA.The first mortar joint friction surface was treated withceramic-ceramic composite in 49 hips,ceramic-polyethylene composite in 19 hips and metal-polyethylene composite in 2 hips.After replacement,hip imaging data were utilized to assess biological fixation of femoral stem prosthesis,osteolysis surrounding the prosthesis,and prosthesis subsidence,and to observe hip function,thigh pain and complications.RESULTS AND CONCLUSION:Al cases were folowed up for more than 2 years.The mean Harris hip score was (32.7±6.2) preoperatively,and improved to (89.2±5.1) during final folow-up.During final folow-up,four patients (6％) suffered from slight pain.No moderate and severe pain or extremely severe pain occurred.None of the patients needed second operation due to failure for various reasons.X-ray films showed that no prosthesis displacement or loosening.Bone fixation surrounding the prosthesis was visible at the femoral side.Only one hip had subsidence of less than 2 mm,and the remaining did not experience subsidence.No blood vessels or nerve injury appeared during the surgery.During prosthesis placement,femoral calcar cleavage fracture occurred in 4 hips,so wire cerclage was used.Deep vein thrombosis in the lower limb or fractures surrounding the prosthesis was not found after placement.These results indicated that the preliminary clinical results of primary total hip arthroplasty with Accolade TMZF cementless femoral stem are encouraging,can effectively improve the function of hip joint.But the folow-up time is shorter,mid-term long-term curative effect should be further observed.

Objective To investigate the pancreas size and echo characteristics of patients with glucose metabolism disorders including type 2 diabetes,and to study its related factors.Methods One hundred and fifty-seven patients from Nanjing Drum Tower Hospital with normal glucose metabolism,impaired glucose regulation,newly diagnosed type 2 diabetes and established type 2 diabetes were collected.The average gray scale intensity of the liver,kidney,pancreas region of interest was measured by using the histogram method.Then the liver and kidney echo ratio,liver attenuation coefficient was calculated,and the fat content of liver was determined by using formula.The size of pancreas head,body and tail was detected by ultrasound,and the sum of three values was used as the pancreas size indicator.Univariate and multivariate logistic regression analysis was performed on the size of pancreas and intensity of echo.Results The size of pancreas ranged from 2.39 ～ 6.09 cm with a mean size of (4.43 ± 0.59) cm,and the size was ≤ 5 cm in 130patients,＞5 cmin 27 patients.The intensity of echo ranged from 41.0 ～ 190.6 with a mean number of 120.0 ±31.1,and the intensity of echo was ≤120 in 83 patients,＞ 120 in 74 patients.The content of liver fat ranged from-1.11％ ～ 62.50％ with a mean number of (15.67± 11.97)％.Univariate logistic regression analysis suggested the size of pancreas was related to age and obesity,and pancreas echo was related to obesity degree,types of participants,the level of blood glucose,and grade of fatty liver (all P ＜ 0.05).Multivariate logistic regression analysis indicated obesity degree is the most important factor for prediction of pancreas size and echo (P ＜ 0.05).Conclusions Quantitative ultrasound measurement of pancreas size and echo can reflect the degree of fat infiltration of pancreas,and it has some clinical value.

Objective To observe the results and reality of transurethral resection of bladder tumor(TUR-Bt) with upside down loop and plsamakinetic in the prevention of obturator nerve reflex.Methods A total of 211 patients with lumbar anesthesia received TUR-Bt.Firstly,the tumor tower above bladder wall was cut with the traditional way.When intraoperative findings were obturator nerve reflex,or to the obturator nerve mapping area,operation should be changed to superimpulse plasma column electrode vaporization to cut off residual tumor tissue,then after flipping the loop,the residual tumour was resected with upside-down loop from the tumour side wall.Results In 211 cases,192 cases had a little obturator nerve reflex,but the movement of body was not obvious,which did not influence the operation.The serious complication,such as perforation of bladder and injury of nerve and vessel,did not occur.Conclusions The lateral resection of bladder side wall tumour with upside-down loop can effectively avoid strong obturator nerve reflex,which is safe,uncomplicated,and efficacious and it does not increase the additional outlay and hurt.

Objective To investigate surgical technique and clinical efficacy of Sky bone ex- pander kyphoplasty in the treatment of osteoporotic vertebral body compression fractures.Methods Eighteen cases with osteoporotic vertebral body compression fractures were treated with Sky bone expander kyphoplasty from August 2004 to November 2005.Under the local anesthesia,3.5-5ml of bone cements were injected into each pathologic vertebral body through unipedicle approach after reduction procedure was done with Sky bone expander.Results The postoperative follow-up ranged from 3 to 11 months, with an average of 4.5 months.Back pain was effectively relieved after the operation in all cases.No complications occurred.Conclusion The Sky bone expander kyphoplasty has the advantages of safe- ty,easy operation,minimal invasion,effective restoration of the vertebral body height and fast relief of pain.

Objective To reinvestigate the value of overnight low-dose dexamethasone suppression test in the diagnosis of Cushing syndrome.Methods Fifty-two patients with Cushing syndrome and 153 patients with simple obesity or essential hypertension in whom Cushing syndrome was excluded were studied retrospectively in order to compare the sensitivity and specificity of different serum cortisol cut-off levels in overnight 1 mg dexamethasone suppression test in the diagnosis of Cushing syndrome.Results The sensitivity of 50% of basal serum cortisol level at 8:00 and of the serum cortisol cut-off levels of 275,200,138,50 nmoL/L at 8:00 after the overnight 1 mg dexamethasone suppression test was 92.3%,92.3%,92.3%,92.3% and 100.0% respectively, and the specificity was 90.8%,98.7%,96.1%,91.5% and 78.4%,respectively.Conclusion The serum cortisol cut-off level of 50 nmol/L in the overnight 1 mg dexamethasone suppression test has very high sensitivity and can be used as a screening test for Cushing syndrome.

AIM:To observe the structural basis of ocular motility abnormalities in patients with congenital fibrosis of the extraocular muscles type Ⅰ ( CFEOM Ⅰ) due to missense mutations in the developmental kinesin KIF21A using high - resolution magnetic resonance imaging ( MRI) .
METHODS: Totally 11 affected individuals reported KIF21A mutations were correlated with MRI studies demonstrating extraocular muscles ( EOMs ) size, location, contractility, and innervation. EOMs and the motor nerve in the orbits were imaged with T1 weighted in a triplanar scan using a dual-phased coils with 2. 0mm thick. Motor nerves were imaged at the brainstem using head coils and 3D-FIESTA with 0. 6-mm thick.
RESULTS: Patients with CFEOM Ⅰ exhibited different degrees of hypoplasia of oculomotor nerve, the abducens nerve and the trochlear nerve were also affected, of which 8 cases of orbital section could see the signal of abnormal nerve dominated by oculomotor nerve to lateral rectus. The both sides of six EOMS in all patients exhibited variable atrophy and abnormal bright internal signal on T1 imaging, particularly severe for the superior rectus and levator muscles.
CONCLUSION: High - resolution MRI can directly demonstrate pathology of motor nerves,affected EOMs, and ‘Pulley' hypoplasia caused by CFEOM Ⅰ due to mutations in KIF21A,and these findings suggest that the neuronal hypoplasia is the etiological factor of CFEOM.

Caused by Helminthosporium carposaprum, tomato brown lea f spot was a serious disease in green house in Henan Province. The condition for promoting sporulation of fungi were tested in this paper. The results showed th at the number of sporulation were different on the different medium,the fungi c ould sporulate a lot on the PDA+tomato leaf and Czapek medium, but V8、PSA and t omato juice restrained sporulation.The best carbon source and nitrogen source f or the fungi promoting sporulation were fructose and ammonium chloride respectiv ely,mannitol and Peptone ammonium sulfate restrained sporulation. Light and ult raviolet radiation were in favor of sporulation , ultraviolet radiation irradiat ing for 60～80min promoted sporulation. The fungi were promoted sporulation on the condition of lower or higher temperature and alkalescence,which 15℃o r 30℃,pH 8～9.

OBJECTIVE:To explore the effects of early treatment with mouse nerve growth factor on the wound healing in aged patients with electric burn. METHODS:78 elderly patients with electric burn were divided into control group and observation group by random number table method,with 39 cases in each group. Control group was given routine method for electric burn, and observation group was additionally given Mouse nerve growth factor for injection 30 μg dissolved in 2 ml 0.9% Sodium chlo-ride injection within 24 h,im,qd,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Clinical effica-cies of 2 groups were compared as well as VAS score before treatment,3,5,7 days after treatment. The survival rate of skin flaps and the rate of wound healing 3,5,7 days after treatment,the recovery of wound scar,the value of wound blood perfusion,the time of complete wound healing and the occurrence of ADR were also compared. RESULTS:The total effective rate of observation group(94.9%)was significantly higher than that of control group(66.7%),with statistical significance(P<0.05). 3,5,7 days after treatment,VAS score of observation group was significantly lower than that of control group,and the survival rate of skin flaps and the rate of wound healing were significantly higher than those of control group,with statistical significance(P<0.05). Af-ter treatment,VSS score of observation group was significantly lower than that of control group,while the value of wound blood perfusion was significantly higher than that of control group;the time of complete wound healing was significantly lower than that of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Early treat-ment with mouse nerve growth factor for elderly patients with electric burns can effectively lower the VAS and VSS score,improve the survival rate of skin flaps and the rate of wound healing,increase the value of wound blood perfusion and shorten the time of complete wound healing with good clinical efficacy and safety.