Nonsyndromic cleft of lip with or without palate ( NSCL/P ) is one of the most common congenital birth defects in the maxillofacial region and it is related to genetic factors and environment .Folic acid deficiency , metabolic disorder and the genetic polymorphisms of key metabolic enzymes may be the important factors contributing to NSCL /P .Maternal folic acid intake may reduce the risk of non syndrome cleft lip and palate .This article will review the relationship among the metabolism of folic acid , the genetic polymorphisms of key enzymes in folate metabolism and NSCL /P .

Objective To investigate the effect of methylprednisolone pulse therapy on spinal nerve functions in patients with acute spinal cord injury (ASCI) and evaluate its safety. Methods 200 patients with ASCI treated in our hospital from January 2010 to December 2016 were selected and were randomly divided into two groups,with 100 cases each group. The patients in control group were treated with routine basic treatment while patients in the study group were treated with methylprednisolone pulse therapy. On the basis of the American spinal cord injury Society scoring criteria (ASIA), the neurological functional recovery scores were performed were scored before and 6 weeks after treatment between the two groups and the adverse reactions were recorded. Results The scores of sensory and motor function of the patients in the two groups were higher than those before the treatment and there was statistical difference (P<0.05), and the scores in the study group was significantly higher than those in the control group, and the difference between the two grouPs was statistically significant (P<0.05). The incidence of adverse reactions in the study group (25.00％) was significantly higher than that in the control group (10.00％), and the difference was statistically significant (P<0.05). The incidence of lung infection and gastrointestinal reaction in the study group were significantly higher than those in the control group and there were statistical difference (P<0.05). Conclusion Methylprednisolone pulse therapy has significant effect on the recovery of neurological function in patients with ASCI, but the incidence of adverse reactions is high, so it is necessary to strengthen the monitoring and intervention in clinic.

Objective To explore the clinical effect of laparoscopic colorectal radical resection combined with simultaneous laparoscopic or open major hepatectomy for synchronous colorectal liver metastases (SCRLM).Methods The retrospective cohort study was adopted.The clinical data of 14 patients with SCRLM who were admitted to the Peking University Third Hospital from July 2010 to September 2015 were collected.Seven patients undergoing total laparoscopic colorectal radical resection combined with major hepatectomy (TLCRMH) were allocated into the TLCRMH group and 7 patients undergoing laparoscopic colorectal radical resection combined with open major hepatectomy (LCROMH) were allocated into the LCROMH group.The statuses of colorectal cancer and metastatic lesions were detected by endoscopy and imaging examination,and diagnostic and therapeutic plans were confirmed through the consultation of muhidisciplinary team.During the hepatectomy,total liver ultrasonography was performed and the extent of liver resection was above 3 hepatic segments.The follow-up of outpatient reexamination was applied to all the patients once every 3 months within postoperative year 2 and once every 6 months after 2 years till December 2015.(1) During operation,method of liver resection,radiofrequency ablation (RFA),operation time,volumes of intraoperative blood loss and blood transfusion,pathological results of primary lesions (T stage,N stage,nerve invasion and canalis haemalis invasion) were collected.(2) After operation,duration of intensive care unit (ICU) care,time for fluid diet intake,postoperative alanine transaminase (ALT),total bilirubin (TBil),complications and duration of hospital stay were collected.(3) Survival of patients and recurrence of tumor were followed up.Count data were analyzed by the chi-sqaure test.Measurement data with normal distribution were presented as x ± s and analyzed using the t test.Measurement data with skewed distribution were described as M(Qn) and M(range) and analyzed using the Mann-Whitney U test.The survival curve was drawn by the Kaplan-Meier method,and overall survival rate and tumor-free survival rate were calculated.The survival analysis was done using the Log-rank test.Results (1) The status of operation:1 and 6 patients in the TLCRMH group underwent respectively left and right hemihepatectomies and 7 patients in the LCROMH group underwent right hemihepatectomy.Four and 6 patients in the TLCRMH and LCROMH groups received local resection of liver metastatic lesions or RFA at segment Ⅱ,Ⅲ or Ⅳ of liver,respectively.The operation time,volumes of intraoperative blood loss and blood transfusion were (651 ± 218)minutes,(1 387 ± 871)mL,(914 ±641)mL in the TLCRMH group and (535 ± 83) minutes,(1 357 ±991)mL,(857 ± 360) mL in the LCROMH group,respectively,with no significant difference between the 2 groups (t =1.320,0.060,0.206,P ＞ 0.05).The numbers of patients in T2,T3,T4,N0,N1,N2 stages,with nerve invasion and canalis haemalis invasion were 1,5,1,3,4,0,3,2 in the TLCRMH group and 0,4,3,1,4,2,2,3 in the LCROMH group,respectively,showing no significant difference between the 2 groups (x2=2.111,3.000,0.311,0.311,P ＞ 0.05).(2) After operation,time for fluid diet intake,ALT,TBil,number of patients with complications and duration of hospital stay were (4.3 ± 1.0) days,(105 ± 47) U/L,(34 ± 25) μmol/L,3 (Ⅲ a,Ⅲ b and Ⅳ a grades of Dindo-Clavien grade),(27 ± 21)days in the TLCRMH group and (4.3 ± 1.1)days,(113 ± 57)U/L,(26 ± 11) μmol/L,4 (Ⅰ,Ⅰ,Ⅱ and Ⅳ a grades of Dindo-Clavien grade),(19 ± 9)days,respectively,showing no significant difference between the 2 groups (t =0.079,-0.286,0.806,X2 =0.286,t =0.856,P ＞ 0.05).The duration of ICU care in the TLCRMH and LCROMH groups were (2.1 ± 1.6) days and (1.0 ± 0.6) days,with a significant difference between the 2 groups (t =1.804,P ＜ 0.05).(3) The status of follow-up:all the patients were followed up for 3-54 months,and the median follow-up time was 15 months (range,3-39 months) in the TLCRMH group and 30 months (range,11-54 months) in the LCROMH group.The 1-,3-year overall survival rates were 100.0％ and 100.0％ in the TLCRMH group and 85.7％ and 64.3％ in the LCROMH group,respectively,showing no significant difference between the 2 groups (x2 =0.676,P ＞ 0.05).The postoperative 1-,2-year cumulative tumor-free survival rates and overage cumulative tumor-free survival time were 64.3％,64.3％ and 20.5 months in the TLCRMH group and 42.9％,14.3％ and 10.9 months in the LCROMH group,respectively,showing no significant difference between the 2 groups (x2=3.160,P ＞ 0.05).Conclusion TLCRMH is safe and feasible for patients with SCLM,and it is comparable with LCROMH in the incidence of postoperative complication and long-term outcomes.

Objective To prepare the sinomenine hydrochloride multivesicular liposomes with high entrapment efficiency and sustained release character.Methods Multiple emulsion method was used to prepare the sinomenine hydrochloride multivesicular liposomes.Uniform design was applied to optimize the formulation and pharmaceutical process.The shape,the particle size,and the release charcter of the liposome were evaluated.Results The sinomenine hydrochloride multivesicular liposomes prepared were spherical and the size of majority particles was in the range of 20—30 ?m and well distributed.The encapsulation efficiency was more than 80% and its in-vitro release profile accorded well with the Higuchi model with t1/2 up to 52.7 h.Conclusion The formulation and pharmaceutical process of the sinomenine hydrochloride multivesicular liposomes are stable and feasible with the high encapsulation efficiency and good sustained-release character.

Endometrial Neoplasms ; metabolism ; pathology ; secondary ; Female ; Humans ; Mesentery ; Middle Aged ; Neprilysin ; metabolism ; Peritoneal Neoplasms ; metabolism ; pathology ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Sarcoma, Endometrial Stromal ; metabolism ; pathology ; secondary

Objective To investigate the effects of penehyclidine (PHCD) pretreatment on nuclear factor kappa B ( NF-kB ) activity during lipopolysaccharide ( LPS )-induced acute lung injury ( ALl ) in neonate rats.Methods Thirty 7-day old Wistar rats of both sexes weighing 18-21 g were randomly divided into 3 groups ( n =10 each): group Ⅰ control (group C); group Ⅱ LPS; group Ⅲ PHCD. Group Ⅱ and Ⅲ received intraperitoneal ( group IP) LPS 3 mg/kg. In group Ⅲ PHCD 5 mg/kg was administered IP at 30 min before LPS respectively. The animals were killed at 4 h after LPS administration. The lungs were immediately removed. The W/D lung weight ratio was measured. The TNF-α, IL-1 βand IL-10 content in the lung were detected by ELISA and expression of NF-kB p65 was detected by immuno-histochemical staining.Results LPS significantly increased W/D lung weight ratio, TNF-α, IL-1 β, IL-10 content and NF-kB p65 expression in the lung as compared with control group. PHCD administered before LPS significantly attenuated the LPS-induced changes. Electron microscopy showed that PHCD before LPS significandy ameliorated the LPS-induced histological damages. Conclusion Pretreatment with PHCD can attenuate LPS-induced acute lung injury though inhibition of NF-kB activation and inflammatory response of lung tissue in neonate rats.

Objective To investigate the effects of lappaconitine on the perioperative immune function.Methods Twenty-four ASA I or II patients aged 23-64 yr undergoing elective radical mastectomy (8 patients),iaminectomy and vertebral canal decompression (8 patients) or femoral head replacement (8 patients ) were randomly divided into 2 groups (n=12 each): control group (C) and lappaconitine group (L).In group L ondansetron 4 mg was given IV and lappaconitine 8 mg was infused IV over 30 rain before induction of anesthesia.In group C equal volume of normal saline was infused instead of lappaconitine.Anesthesia was induced and maintained with propofol,remifentanil and rocuronium.Lappaconitine 0.28 mg/ml was continuously infused at 2 ml/h after induction of anesthesia in group L.When the patients recovered from anesthesia after operation,PCA with 0.28 mg/ml lappaconitine was started (background infusion 2 ml/h,bolus dose 0.5 ml and lockout interval 15 min).In group C pethidine 50 mg and droperidol 2.5 mg were given IM on demand.Venous blood samples were taken at 30 rain before induction of anesthesia(T1,baseline),immediately (T2) and at 24 h(T3) and 48 h (T4)after operation for determination of TNF-α,IL-2,IFN-γ and sIL-6R concentration by ELISA.CD3,CD4,CD8 and NK cell expression was determined using flow cytometry and the ratio of CD4/CD8 was calculated.The concentrations of IgA,IgM,IgG,CD3 and CD4 were determined by radioimmunoassay.Results Plasma SIL-6R and TNF-α concentrations were significantly lower while IL-2,IgA,IgG,IgM concentrations and CD4/CD8 ratio were significantly higher after operation in group L than in group C.Conclusion Lappaconitine can improve perioperafive humoral immune function thus contributing to its analgesic and anfi-inflammatory effects.

Objective To study the correlation of the level of high-sensitivity C-reactive protein (Hs-CRP) in the acute phase of ischemic stroke and progressive stroke. Methods 101 patients with acute ischemic stroke were collected. Serum Hs-CRP of all patients were measured at 24 hours after admission , the onset of 48 hours, the onset of 72 hours by latex enhanced immune turbidity method. According to their serum Hs-CRP lev-els, the patients were divided into the group of Hs-CRP sustained growth (n = 35) and the group of non Hs-CRP sustained growth (n = 66). The NIHSS scores were assessed on two groups of patients , Logistic regression analysis was made to screen the related factors of Hs-CRP increase and the possible risky factors for progressive ischemic stroke. Results There was a significant difference of serum Hs-CRP level between the two groups (P <0.001). The incidence of progressive stroke in the group of Hs-CRP sustained growth was significantly higher than that in the group of non Hs-CRP sustained growth (χ2 = 32.710, P < 0.001). Logistic regression analysis showed blood glucose , white blood cell count , triglyceride level and NIHSS scores at admission were associated with sustained growth of Hs-CRP and the factors that they included Hs-CRP sustained growth , admission NIHSS scores, diabetes mellitus and pulmonary infection were regarded as independent risk factors. Conclusion The sustained growth of Hs-CRP in the acute phase of ischemic stroke is an independent predictor of progressive stroke.

Objective To measure the fractional anisotropy(FA) values in the language function areas(Broca area,Wernicke area and arcuate fasciculus)by diffusion tensor imaging(DTI),discussing the pathological characteristics in cerebral palsy children with language development delay.Methods DTI was performed in twenty-seven cerebral palsy children with language development delay(observation group) and 20 children with febrile seizures(control group) by Philips 3.0T MRI scanner.The FA values of Broca area,Wernicke area and arcuate fasciculus were measured at Philips Workstation.Results The FA values of control group in the left Broca area,Wernicke area and arcuate fasciculusis were higher than those of the right side,and the difference was statistically significant (all P ＜ 0.05).The FA value of observation group in the left Broca area was lower than that of the right side,and the difference was statistically significant (P ＜ 0.05);the FA values of observation group in the left Wernick area and arcuate fasciculusis were higher than those of the right side,but the difference was not statistically significance (all P ＞ 0.05).The FA values in the bilateral Broca area and arcuate fasciculusis of observation group were lower than those of the control group,the difference was statistically significant (P ＜ 0.05),those in the bilateral Wernick area were also lower than the control group,but the difference was not statistically significant (P ＞ 0.05).Conclusions The main pathogenesis for language development delay in cerebral palsy children was extensive damage in language functional areas,and Broca area and arcuate fasciculus were markedly impaired than Wernick area.

Delicacy management proves a pressing need in cost management of medical service items in the current hospital operation.This paper first covered the methodology and system of hospital costing.It went on to describe the costing for four major medical service items in a quarter in 2011 using the activity-based costing method with the ultrasonographic section of a large hospital as an example.The outcomes were compared to the traditional costing method and the statutory pricing standards,resulting in the proposal and recommendation on reforming the costing methodology of service item pricing,and applying the activity-based costing management of medical service items in the hospital.