Objective To retrospectively analyze the importance of preoperative ultrasound and D-dimer determination for patients with traumatic fractures so as to evaluate the value of vascular color Doppler ultrasound in diagnosing of vein thrombosis and the correlation between D-dimer level and lower extremity vein thrombosis. Methods The study involved 1000 in-patients with multiple traumatic fractures, femoral fractures, tibial fractures or tibiofibular fractures admitted from March 2008 to April 2009 who were prepared for open reduction surgery. There were 568 males and 432 females, at age range of 20-90 years ( average 54.8 years). Vein D-dimer was examined in the morning on the second day after admission. Vascular color Doppler ultrasound was performed on the lower extremity one day before operation (after the swelling faded away, about 4-10 days after fracture). Results The vascular color Doppler ultrasound on the lower extremity showed vein thrombosis of the lower extremity in 64 patients (6.4%) including 26 patients with iliac- femoral vein thrombosis, 10 with popliteal-tibial vein thrombosis and 28 with gastrocnemius or soleus muscle vein thrombosis. On the second day after operation, out of 736 patients (73.6%) with D-dimer above normal (324 μg/L), 56 patients (7.6%) developed thrombosis afterwards;of 264 patients (26.4%) with normal D-dimer, eight patients (3.03%) developed thrombsis. Incidence of thrombosis in patients with D-dimer above 650 μg/L was higher than that in patients with D-dimer below 650 μg/L (P＜0. 01). Conclusions Preoperative lower extremity vein Doppler ultrasound in traumatic fracture patients can lower the risk of fatal lung thrombosis caused by existing deep vein thrombosis.D-dimer above normal level indicates tendency of thorombosis. However, normal D-dimer still have the possibility to develop thrombosis, which deserves attention.

Objective To investigate neural correlates of the generation,execution and inhibition of motor intention. Methods Behavioral performance and event-related potentials (ERP) of 14 participants were recorded when they performed a two-staged Go-Nogo task. At the stage of intention preparation,three kinds of the "what" cues were presented separately to the participants : (1) to press a response key by the left or the right hand (the instructed) ,(2) to decide freely which hand will be used (the free) ,(3) to wait for the second cue (the control). At the stage of intention execution,the "whether" cue suggested the participants execute (Go) or withdraw (Nogo) the previous intention either voluntarily or forcedly. Results The interaction effect between the "what" and the "whether" was significant(F(2,26) = 8.262, P=0.002). The forced responses were faster than those of voluntary action under both the instructed condition ((468.52 ±105.87)ms vs (546.67 ±146.33)ms) and the control condition ((536.78 ± 83.28) ms vs (589.75 ± 140.80) ms). No significant difference was found for the free condition((538.71 ± 127. 39) ms vs (561. 44 ± 146. 51) ms). At the stage of intention preparation,significant ERP effects between the instructed intention and the freely intention were revealed in bilateral frontal regions (150～200 ms) , frontoparietal area (300～700 ms)and right temporal area. At the stage of intention execution,ERP effects between voluntary inhibition and voluntary action were observed in left prefrontal area (160～220 ms) ,fro-nto-cento-parietal area and right frontoparietal area. (300～550 ms). Conclusion The motor intention may be generated in the prefrontal area and maintained in the frontoparietal network. The left prefrontal and fronto-centro-parietal areas inhibit intention in the early stage and the right frontoparietal area involves response inhibition lately.

Objective To investigate neural correlates of the retrieval of temporal order.Methods ERP of 19 channels was recorded from 17 healthy young students while they performed a recency judgment task,a recognition task and a visual discrimination task separately,which were based on Sternberg paradigm.One-way ANOVA of repeated-measurement and post-hoc paired comparisons were carried out for both the task factor(temporal order,recognition and control)and the temporal distance factor correspondingly.The latter contains 3 intervals (1,2 and 3)between the targets.Results The temporal distance effect was significant:the closer targets correspond to longer reaction time((745.5±106.1)ms,(711.7±102.2)ms,(653.7±81.5)ms;F_((1.28,20.48))=43.37,P=0.00]and higher error rate((62.8±7.0)%,(72.5±5.4)%,(84.5±6.4)%;F_((1.32,21.11))=135.99,P=0.00].Significant behavioral effect of the task factor was also found for both reaction time(F_((1.32,21.11))=135.99,P=0.00)and error rate(F_((2,32))=200.31,P=0.00).No significant behavioral difference was found between the temporal order group and the recognition group.The spatiotemporal pattern of statistical parametric mapping(SPM)suggested the ERP effects of temporal order were presented in left temporal region (260～270 ms),bilateral parietal-occipital areas(280～290 ms),and bilateral parietal lobes(300～400 ms)prominently.No ERP effect was found between the temporal order task and the recognition task.Conclusions The neural correlates of the temporal distance effect exist in bilateral parietal regions.Temporal order as well as object information processing involves similar cerebral regions during the retrieval period.

UNLABELLEDABSTRA CT OBJECTIVE To compare the complications and clinical outcome of titanium elastic nail (TEN) versus plate-screw fixation (PF) for the treatment of upper segment fractures of femoral shaft in children.

METHODSFrom May 2006 and August 2012,32 consecutive children with upper segment fractures of femoral shaft were studied prospectively. They were randomly divided into TEN group and PF group. Ninteen patients were treated with titanic elastic nail (TEN) fixation including 11 males and 8 females with an average age of (6.9?2.2) years old ranging from 3 to 11,11 cases of them were type A, 6 cases were type B,2 cases were type C according to AO classification. The other 13 patients were treated with plate-screw fixation (PF) including 9 males and 4 females with an average age of (7.5±2.1) years old ranging from 5 to 12 years, and 3 cases of them were type A,6 cases were type B,2 cases were type C. Operative time, blood loss,incision length,the time of hospitalization,fracture healing time, postoperative complications and function recovery between two groups were compared and evaluated.

RESULTSThe average follow-up period of the patients was 25.3 months (ranging from 15 to 48 months) in TEN group, and 36.2 months (ranging from 13 to 36 months) in the PF group. The operation time, time of hospitalization, the time of implants removed after the initial surgery, fracture healing time in TEN group were respectively (56.7±11.2) min, (6.6±3.9) d, (8.1±2.3) months, (12.6+3.8) weeks; and in PF group were respectively (51.5±8.3) min, (7.8±4.8) d, (7.8±1.6) months, (11.8±2.8) weeks, there was no significant difference between two groups (P>0.05). However, the length of incisions was (4.3±1.7) cm and the intraoperative blood loss was (12.7+3.2) ml in TEN group,which were significantly less than that in PF group respectively (89.2±21.1) ml and (11.6?2.3) cm (P<0.05). There was no statistically difference in postoperative in complication between two groups, but the patients in TEN group had a higher incidence of soft tissue irritation and misalignment. Outcome scores according to Sanders had no significant difference between two groups (P>0.05). In TEN group,the result was excellent in 13 cases, good in 3,fair in 2, and poor in 1, while in PF group excellent in 10, good in 2, fair in 1.

CONCLUSIONThere is no significant difference in therapeutic effects between TEN and PF for children with upper segment fractures of femoral shaft. The internal fixation should be selected according to the associated fracture type, weight, the expected value of the parents, scars, and so on.

Blood Loss, Surgical ; Bone Nails ; Bone Plates ; Bone Screws ; Child ; Child, Preschool ; Female ; Femoral Fractures ; complications ; physiopathology ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; Fracture Healing ; Hip ; physiopathology ; Humans ; Male ; Operative Time ; Postoperative Complications ; epidemiology ; Prospective Studies ; Treatment Outcome

Objective To evaluate the early effects of bone cement prostheses versus cementless prostheses in very elderly patients undergoing total hip arthroplasty.Methods A total of 110 patients aged 70 years and over who had undergone hip replacement because of hip disease from March 2011 to March 2013 were selected.104 cases were followed up for 3 years,with 46 cases treated with the bone cement prostheses(Group A) and 58 cases with cementless prostheses(Group B).The conditions before and after surgery were recorded.Postoperative Harris scores were collected to evaluate the function of the hip joint,and the loosening of hip prostheses was detected by x-ray.Results Intraoperative blood loss and postoperative drainage volume were lower in Group A than in Group B [(236.0±26.3) ml vs.(296.0±34.5) m1,(123.0±20.3) ml vs.(156.0±26.4) ml,both P ＜0.05].Harris scores before,6 months,1,2 and 3 years after surgery were(40.2±7.2),(80.3±5.2),(90.2±4.5),(90.6±4.2),and(90.8±3.5) in Group A,and(39.8±6.3),(76.5±8.7),(86.5±5.1),(89.3± 4.8),and(91.0± 4.1) in Group B,respectively.Harris scores 6 months and 1 year after surgery were higher in Group A than in Group B,and there was no significant difference in Harris scores between the two groups 2 and 3 years after surgery(P＞0.05).Pain scores before,6 months,1,2 and 3 years after surgery were(13.5± 5.3),(37.5± 6.2),(38.4±5.3),(39.1 ±2.5) and(39.0±2.1) in Group A and(12.9±6.2),(30.2±8.7),(35.9±6.5),(38.6±4.8) and(39.2±2.6) in Group B,respectively.Pain scores 1 year after surgery was better in Group A than in Group B,and there was no significant difference in pain scores between the two groups 2 and 3 years after surgery(P＞0.05).Bone cement implantation syndrome occurred in 6 cases in Group A,of which 1 case had respiratory and cardiac arrest and was successfully rescued after cardiopulmonary resuscitation.In addition,in Group A,1 case had osteolytic disease 2 years after surgery,and,in Group B,4 cases had proximal femoral fractures and 1 case had osteolytic disease 3 years after surgery.Conclusions For very elderly patients undergoing total hip replacement,satisfactory early therapeutic effects can be achieved by using bone cement or cementless prostheses.Intraoperative blood loss,postoperative drainage volume and Harris scores 1 year after surgery are better with bone cement prostheses than with cementless prostheses.Close attention should be paid to possible development of bone cement implantation syndrome during operation.

Anesthetics, Intravenous ; administration & dosage ; pharmacology ; Animals ; Animals, Newborn ; Cerebral Cortex ; cytology ; metabolism ; Drug Synergism ; Female ; Fentanyl ; administration & dosage ; pharmacology ; Male ; Midazolam ; administration & dosage ; pharmacology ; Neurons ; metabolism ; Patch-Clamp Techniques ; Primary Cell Culture ; Rats ; Rats, Sprague-Dawley ; Voltage-Gated Sodium Channels ; drug effects

In response to viral infection, RIG-I-like RNA helicases detect viral RNA and signal through the mitochondrial adapter protein VISA. VISA activation leads to rapid activation of transcription factors IRF3 and NF-κB, which collaborate to induce transcription of type I interferon (IFN) genes and cellular antiviral response. It has been demonstrated that VISA is activated by forming prion-like aggregates. However, how this process is regulated remains unknown. Here we show that overexpression of HSC71 resulted in potent inhibition of virus-triggered transcription of IFNB1 gene and cellular antiviral response. Consistently, knockdown of HSC71 had opposite effects. HSC71 interacted with VISA, and negatively regulated virus-triggered VISA aggregation. These findings suggest that HSC71 functions as a check against VISA-mediated antiviral response.
Adaptor Proteins, Signal Transducing ; biosynthesis ; chemistry ; genetics ; metabolism ; Cell Aggregation ; genetics ; GPI-Linked Proteins ; metabolism ; Gene Knockdown Techniques ; HEK293 Cells ; HSC70 Heat-Shock Proteins ; genetics ; metabolism ; Heat-Shock Response ; genetics ; Humans ; Interferon Regulatory Factor-3 ; genetics ; metabolism ; Interferon-beta ; genetics ; NF-kappa B ; genetics ; Prions ; metabolism ; Receptors, Retinoic Acid ; metabolism ; Viruses ; drug effects ; metabolism ; pathogenicity

Animals ; Animals, Newborn ; Cells, Cultured ; Fibroblasts ; cytology ; metabolism ; Myocardium ; cytology ; Pravastatin ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; genetics ; metabolism

Objective To evaluate the safety of coronary intervention using iodixanol in patients with diabetic renal insufficiency.Methods Clinical data of 97 patients with diabetic renal insufficiency undergoing coronary intervention during June 2004 to June 2006 were retrospectively analyzed,50 of them with iodixanol,an iso-osmolar contrast medium (iodixanol group),and 47 with iopromide,a hypotanic contrast medium (iopromide group).Judkin's coronary angiography showed 167 diseased vessels in the patients,65 in anterior descending branches,44 in circumflex branches,and 58 in right coronary arteries. Levels of serum creatinine and blood urea nitrogen were determined before percutaneous coronary intervention (PCI),on the day of the procedure,the 3rd and 7th days after PCI,respectively,as well as radiocontrast media-induced nephropathy (CIN) was observed.Results Totally,192 drug-eluting stents were successfully implanted in 167 diseased vessels,and all patients' angina pectoris symptom disappeared soon after the procedure,with a full success.No acute or subacute stent thrombosis and major adverse cardiac events (MACE) occurred.Two patients (4%) in iodixanol group and 10 (21%) in iopromide group got CIN,with a statistical significance (P

Objective:To investigate the protective effect of intensity-modulated radiotherapy (IMRT) on salivary gland function in nasopharyngeal carcinoma (NPC) patients. Methods:In total, 101 NPC patients who were admitted from March 2010 to November 2012 were enrolled in this study. The parotid gland, the submandibular gland, and the oral cavity were sketched as the organs at risk (OARs). The patients were treated with IMRT and were evaluated through a face-to-face interview using a dry mouth assessment ques-tionnaire during the follow-up visits at 3, 6, 12, 18, and 24 months. The dose volume histogram of the salivary gland of the patients was also considered. Results:The mean doses (MDs) in the parotid gland were 37.4 and 33.8 Gy in the affected and uninjured sides, respec-tively. Meanwhile, the MDs in the submandibular glands were 51.6 and 45.7 Gy in the affected and uninjured sides, respectively. The MD of the oral cavity was 38.2 Gy. At 6 months after the treatment, the symptom of xerostomia was significantly improved in 77.2%of the patients (78/101). One year later, only less than 5%of the patients complained of having G3 or higher-grade xerostomia. Conclu-sion:With time, xerostomia significantly improved after the radiotherapy. At least one of the V30 to V35 of the parotid gland was≤50.0%, whereas at least one of the V40 to V45 of the submandibular glands was≤66.7%~50.0%. The MD for the oral cavity should be<40 Gy to effectively protect salivary gland function.