Objective To compare medium-term therapeutic effect by bilateral and unilateral puncture plasma coblation nucleoplasty(PCN) in the lumbar disc herniation patients. Methods 90 cases confirmed no significant rupture of annulus fibrosus of lumbar disc herniation by CT or MRI were randomly divided into two groups. Bilateral and unilateral puncture plasma coblation nucleoplasty groups were respectively divided into group A and group B, and compared the JOA scores. Results 82 patients were followed up for 10 ～ 32 months,the average follow-up time was 16.2 months. Preoperative JOA scores of the two groups were not statistically significant(P ＞ 0.05) but the postoperative follow-up JOA scores were higher than preoperative(P ＜0.05) and the JOA scores of group A were higher than group B(P ＜0.05). Conclusion The medium-term therapeutic efficacy of bilateral puncture coblation nucleoplasty was superior to unilateral therpy.

Objective To evaluate the efficacy of Grosse Kempf interlocking intramedullary nailing (Grosse Kempf IIN) and AO plate in the treatment of tibial fractures. Methods A retrospective analysis was done on the recovery of 55 cases with tibial fractures treated with the Grosse Kempf IIN (Group A) and 40 treated with AO plate (Group B) from 1994. Results The 10 26 months follow up showed that the healing rate and the infection rate were 98.2% (54/55) and 1.8% (1/55) respectively in the Group A with a mean healing time for 5.6 months and 90.0% (36/40) and 12.5% (5/40) respectively in the Group B with a mean healing time for 7.5 months. Conclusions The Grosse Kempf IIN has obvious advantage of excellent biodynamics, reliable fixation, simple operation, less trauma on regional blood supply and is more effective in the treatment of tibial fractures than the AO plate. Nevertheless, I IN itself has limitation for further application.

Objective To analyze the comparability and correlation of reticulocyte parameters on the Beckman‐Coulter LH780 (LH780)and Sysmex XN‐1000(XN‐1000)hematology analyzers .Methods 80 blood samples were measured by the two instru‐ments ,the RBC count ,percentage of Ret(Ret% ) ,Ret value(Ret#)and immature reticulocyte fraction(IRF) were analyzed ,and the correlation of Ret% ,Ret# and IRF between two instruments were also analysed .The correlation between percentage of high laser reticulocyte(HLR% ) of LH780 and percentage of middle fluorescent reticulogyte(MFR% )+percentage of high fluorescent reticu‐locyte(HFR% ) of XN‐1000 were compared using two calculation methods of each instrument ,and the application value of HLR%were analysed .Results No significant differences were founded in RBC count ,Ret% ,and Ret# between the two instruments(P>0 .05) ,while there was statistical difference in IRF between the the two instruments (P<0 .05) .The relative deviation coincidence rate of RBC count was 97 .5% ,the correlation coefficent (r) of Ret% ,Ret# and IRF were 0 .912 ,0 .895 and 0 .666 respectively . There were statistical differences and correlations between HLR% and MFR% + HFR% when using calculation method of XN‐1000 and LH780 respectively(r were 0 .666 and 0 .767 respectively ,P<0 .05) .Conclusion The RBC count could meet the matc‐hing requirement ,and the Ret% and Ret # may be highly correlated on the two instruments .While the reference range of IRF should be established in each instrument .

OBJECTIVE To detect genes sul1 and sul2 in Stenotrophomonas maltophilia,and their relationship to drug resistance to trimethoprim-sulfamethoxazole(SXT).METHODS K-B was carried out to detect the drug resistance to SXT of S.maltophilia;minimal inhibitory concentration(MIC) was measured with micro broth dilution method.Genes sul1 and sul2 were amplified by PCR.RESULTS Eight isolates(7.8%) showed resistance to trimethoprim-sulfamethoxazole,sul1 Was positive in four isolates in which one contained sul2 also.Four isolates showed high MIC to SXT.CONCLUSIONS Genes sul1 and sul2 of S.maltophilia are associated with the high drug resistance to SXT.

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.

Objective To establish an early cognitive disorder model in rats and investigate the early cognitive functioning after ischemic hypoxic brain injury during the neonatal period. Methods Forty-six newborn Sprague-Dawley rats were randomized into a 21-d-old group and a 31-d-old group. These 2 groups were then subdivided into model and sham-operated subgroups (M21, n=12; SH21, n=11; M31, n=12; SH31, n=11). A model of neonatal early cognitive disorder was established in the rats of the M21 and M31 groups using a modification of Rice's method. Rats in the SH21 and SH31 groups received skin incisions and common carotid artery separation without ligation or hypoxia. Each group was tested with a Morris water maze. The rats were sacrificed after testing, and brain tissue was examined under the electron microscope. Nissl staining allowed Nissl body quantification and neurocyte acin the M21 group was significantly longer than in the SH21 group. The 31-d-old subgroups had shorter average escaping latencies than the corresponding 21-d-old subgroups. (b) Spatial memory: The average platform times, Ⅰ region times and Ⅰ region distances showed no significant differences among groups. ②Brain pathology (a) Gross appearance: Obvious ischemic hemisphere atrophy was observed in the M group, and no abnormality was observed in the SH group. (b) Electron microscopic observation: In the SH group cell ultrastructures in the ischemic hippocampus were normal. Karyopyknosis and dilated endoplasmic reticulums were found in the M group. More mitochondria were found in the presynaptic membranes of the ischemic hippocampus in the M group than that in the SH group. (c) Nissl body quantification and neurocyte activity analysis: Significantly less activity in the ischemic cortex was found in the M21 group compared to the SH21 group. More activity was observed in the 31-d-old subgroups than in the corresponding 21-d-old subgroups. Conclusions ①The neonatal rats with ischemic hypoxic brain injury had prolonged average escaping latency and depressed neuronal activity. ②The 31-d-old rats had better spatial localization learning ability than the 21-d-old rats.

Objective To detect the effect of low-dose heparin on endothelial function by detecting the change of yon Willebrand factor (vWF) in blood plasma of patients with sepsis shock after treatment with low-dose heparin in order to observe organ function and prognosis of patients.Methods A total of 118 patients with sepsis shock were randomized into low-dose heparin group and control group.In addition to the routine treatment,the patients in low-dose heparin group were given low-dose heparin,while those in control group were not.The levels of APTT,PT,platelet (PLT) count,hepatic function and renal function were determined before and after treatment in two groups,and hemorrhagic events or other complications were recorded.The lengths of stay in ICU and in hospital,the days of mechanical ventilation and the rates of acute respiratory distress syndrome (ARDS),disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) and 28-day survival rate in the two groups were documented.The levels of vWF in patients of two groups were determined by using immunoturbidimetry before and after treatment.Results The rates of DIC and MODS in low-dose heparin group decreased significantly after therapy (rate of DIC,10.6％ vs.26.7％,P ＜ 0.05;rate of MODS,19.3％ vs.32.0％,P ＜ 0.05).Hepatic function and renal function in low-dose heparin group were significantly improved than that in the control group (P ＜ 0.05),28-day survival rate in the low-dose heparin group was higher than that in the control group (78.3％ vs.69.1％,P ＜0.05),the differences between low-dose heparin group and control group were not statistically significant in the lengths of stay in ICU and hospital,the days of mechanical ventilation and the rate of ARDS (P ＞ 0.05).The differences in APTT,PT and PLT were not significant from pre-treatment to after treatment and between the two groups (P ＞ 0.05).The levels of vWF in low-dose heparin group decreased significantly after therapy rather than those in control group (P ＜ 0.05).Conclusions The endothelial function is improved in patients with sepsis shock after employment of lowdose heparin.Low-dose heparin alleviates the interaction between coagulation and inflammation,improves hepatic,renal and other important organs function,decreases the rate of MODS and increases 28-day survival rate patients with sepsis.The low-dose heparin therapy is a safe and promising treatment in sepsis patients without severe side effects.

Objective To investigate the accuracy and reliability of white blood cell classifications in normal saline diluted jaundice specimen which could not be classified by blood cell analyzer. Methods Jaundice specimens which not be classified were equally diluted with normal saline and assessed in LH750. Differential count of white blood cells after dilution was compared with the result of original specimen using XN-1000 blood cell analyzer. The white blood cell classifications of diluted jaundice specimen and the original blood sample were analyzed. Results In jaundice specimens diluted by normal saline, when WBC ＜2. 0 ×109/L, minimum relative deviation was 0％ and the maximum was 9. 03％. When WBC＞2. 0xl09/L, minimum relative deviation was 0. 09％ and the maximum was 5. 21％. All the results met the requirements. Conclusion Equal dilution of normal saline could preliminarily solve the problem that white blood cells could not be classified in jaundice specimen.

Objective To evaluate the efficacy and complications of component blood transfusion combined with recombinant activated factorⅦa(rFⅦa)in treatment of severe active hemorrhage after cardiac surgery??Methods Fifty patients who suffered from severe active hemorrhage after cardiac surgery were selected from the First Affiliated Hospital of Dalian Medical University from July 2015 to May 2017??All patients were divided into GR group ( component blood transfusion combined with rFⅦa) and GA group (component blood transfusion combined with tranexamic acid) by random number table method,25 cases in each group??The changes of disseminated intravascular coagulation (DIC) were screened on admission(D1), after cessation of cardiopulmonary bypass ( D2 ), and 2 h ( D3 ), 6 h ( D4 ) and 12 h ( D5 ) after medication??The difference of activated partial thromboplastin time (APTT), international normalized ratio (INR),fibrinogen,hemoglobin and platelet of the two groups at each time point of D1,D2,D3,D4 and D5 were analyzed??Meanwhile, the postoperative drainage, postoperative blood transfusion, postoperative plasma transfusion volume, postoperative mechanical ventilation time, ICU retention time, the 30 d mortality and complications were compared between the two groups??Results There were significant differences in APTT, INR,fibrinogen,hemoglobin and platelet between the two groups ( all P＜0??05)??There was no significant difference in the indices of DIC screening between the two groups at D1, D2 and D5 time points ( all P＞0??05),but at D3 time point,APTT in GR group was significantly shorter than that in GA group((50??3 ±6??6)s vs??(60??1±6??5)s,P＝0??027),and INR in GR group at D4 time point was also significantly lower ((1??3 ± 0??3) vs??( 1??5 ± 0??3), P＝0??041)??In addition, the amount of red blood cells transfusion after treatment in GR group and GA group (( 3??2± 1??0) U vs??(4??1 ± 1??0) U,P＝0??005),the amount of fresh plasma transfusion ((303??2±98??5) ml vs??(469??6± 190??5) ml,P＝0??000),the amount of 24 h drainage after operation ((519??9±107??5) ml vs??(657??2±100??1) ml, P＝0??000) were significantly decreased,the differences were statistically significant??Conclusion Blood component transfusion combined with rFⅦa can significantly improve APTT and INR of severe active hemorrhage after cardiac surgery,at the same time,it can reduce the amount of red blood cells transfusion and plasma transfusion??

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with split hand/foot malformation (SHFM). METHODS: Genomic DNA of the proband and other affected members was extracted from peripheral blood samples. Chromosomal microarray analysis was employed to detect genome-wide copy number variations (CNVs). RESULTS: A 400 kb microduplication was identified in the 10q24.31-q24.32 region among all affected individuals. The microduplication has involved four genes, namely LBX1, BTRC, POLL and DPCD, in addition with part of FBXW4 gene. CONCLUSION The 10q24.31-q24.32 microduplication has segregated with the disease phenotype in this pedigree and probably underlay the SHFM malformation in the patients.
Asian Continental Ancestry Group ; Chromosome Duplication ; Chromosomes, Human, Pair 10 ; genetics ; DNA Copy Number Variations ; Foot Deformities, Congenital ; genetics ; Genetic Testing ; Hand Deformities, Congenital ; genetics ; Humans ; Limb Deformities, Congenital ; genetics ; Pedigree