Amino Acid Metabolism, Inborn Errors ; etiology ; therapy ; Glutarates ; blood ; Humans ; Infant, Newborn ; Male

Objective To explore the effect of water analgesia on the pain relief for primiparas in labor, especially on the point of the acutest pain and total time of severe pains by tracking and comparing with remifentanil patient- controlled intravenous analgesia and the conventional vaginal delivery. Methods A total of 139 singleton and full-term primiparas who chosed analgesia labor were selected. There were 3 groups:56 cases in water analgesia group (hereinafter referred to shortly as water group), 37 cases in remifentanil patient-controlled intravenous analgesia group (hereinafter referred to shortly as vein group ) and 46 cases in traditional vaginal delivery group (hereinafter referred to shortly as traditional group). In addition, labor pain intensity was assessed with numerical rating scale (NRS). All groups were evaluated by NRS score in five different time points during the delivery:cervical dilation to 2-3 cm or 1 minute before labor analgesia; labor analgesia after 10 minutes; labor analgesia after 30 minutes; labor analgesia after 60 minutes;point of acutest pain. Meanwhile, total time of acutest pain, progress of labor, use of oxytocin, mode of delivery, postpartum hemorrhage and neonatal asphyxia were all observed. Results Comparison of labor progress and postpartum bleeding, mode of delivery and neonatal Apgar score in three groups of primipara showed no significant difference (P>0.05). Compared with the traditional group, the NRS score and point of acutest pain in water group obviously declined, the total time of severe pain shortened 36.58 min on average, which showed significant difference (t=-4.400, P<0.05). Compared with the vein group, the NRS score of water group at 10 minutes after labor analgesia was below the vein group (t=-2.358, P<0.05), so was point of acutest pain (t=-2.703, P<0.05). But the score of water group was higher than intravenous analgesia after 60 minutes, which showed significant difference (t=2.833, P<0.01). The rate of oxytocin application in water group was only 12.5%(7/56), significantly less than the rate in vein group, which was 37.84%(14/37), there were significant differences (χ2=8.182, P<0.05). Conclusions Water analgesia can effectively alleviate maternal pain and reduce intrapartum intervention, and more, less influence on maternal and newborn, and is a safe and effective analgesia method.

Objective To study the advantage and disadvantage of different treatments of unstable distal radial fractures in elderly patients. Methods In the period from August 2005 to January 2010, 55 elderly patients with unstable d istal radial fractures were treated with manual diaplasis and external plaster splint fixation, operation and internal plate fixation, or external fixation. Clinical outcomes were evaluated by Gartland-Werley wrist scoring systems and questionnaire of the disabilities of the Arm, Shoulder and Hand (DASH). We used SPSS13.0 software package for statistical analysis. Results Compared with the manual diaplasis group, the operation and internal plate fixation group or external fixation group was better in Gartland-Werley scores, the differences were statistically significant (P<0.05), but there were no differences in DASH scores among the 3 groups. Conclusions The treatment of unstable distal radial fractures in elderly patients should be chosen based on the characteristics of the fractare and patients desire.

OBJECTIVE: To summarize the progress on the biomaterials of chitin nerve conduit to repair peripheral nerve injury in recent years.DATA SOURCES: A computer-based online search of literatures related to the application of the biomaterials of nerve conduit on peripheral nerve injury was performed in Medline and Springerlink by using the key words of "nerve conduit, peripheral nerve injury" between January 2000 and August 2009 and the language was limited to English. Meanwhile, we searched China Periodicals Full-text Database and Weipu database for the related Chinese articles published between January 2000 and August 2009 with the same key words in Chinese.STUDY SELECTION: Inclusive criteria: Researches about the non-biodegradable materials, biodegradable materials and biological derivative materials that were related to the peripheral nerve injury were included. Exclusive criteria: The irrelevant and repeated articles were excluded.MAIN OUTCOME MEASURES: Nerve tissue engineering, chitin nerve conduit, and preparation of nerve conduit.RESULTS: With the progress of medical materials, the neural tube of natural or synthetic materials used to bridge defect of the neural in nerve tissue engineering scaffold material with a guide and to promote nerve regeneration. In the biodegradable material, chitin neural tube could be degraded within a reasonable period of time, biological control compatibility, performance degradation, mechanical properties and porosity. And in the structure of the conduit, combined other biodegradable materials,surface modification, adding seed cells and nerve growth factor, and other aspects of the experimental study were investigated.Changing the spatial structure of renewable and micro-environment aimed to speed up the rate of nerve growth, and promote the resumption of the good nerve function. And material's surface had to be modified and improved for conduit to adapt nerve during the nerve regeneration.CONCLUSION: With the continued development of biotechnique and cross-correlation technique, the biomaterials of chitin nerve conduit will have a prosperous future on peripheral nerve tissue engineering.

BACKGROUND:The open reduction and internal fixation in treatment of middle and inferior humeral fractures often choose anterolateral approach. As the rapid development of microsurgical technique in recent years, some domestic hospitals try to adopt the medial approach, but the operation safety and efficacy are rarely reported. OBJECTIVE:To evaluate the clinical efficacy of two different approaches of open reduction and internal fixation for treating the middle and inferior humeral fractures.
METHODS:A total of 68 patients with the middle and inferior humeral fractures were selected from Orthopedic Center of Xinjiang Medical University from January 2010 to January 2012, and were retrospectively analyzed. According to the approach of incision, the involved patients were divided into anterolateral approach group (n=33) and medial approach group (n=35). The blood loss in two groups was analyzed using Gross equation. The postoperative complications and functional recovery were compared.
RESULTS AND CONCLUSION:During the fol ow-up at 12-18 months, X-ray results showed that the fractures achieved bone healing, fracture healing time was 16.9±3.9 weeks in anterolateral approach group and 15.5±2.2 weeks in the medial approach group. Shoulder Neer system score was 86±5 points in anterolateral approach group and 84±4 points in the medial approach group;elbow Mayo system score was 78±7 points in anterolateral approach group and 81±8 points in the medial approach group. Three cases in anterolateral approach group and one case in medial approach group presented postoperative radial nerve numbness and wrist dorsiflexion weakness, which were self-healed after 3 months. There was no nonunion, chronic osteomyelitis for other complications. The fracture healing time, the incidence of complications and the functional recovery between the two groups showed no significant difference (P>0.05). The medial approach is a feasible and safe surgical approach of internal fixation for treating the middle and inferior humeral fractures.

BACKGROUND: In recent years, it has been confirmed by a variety of ways that myoblasts can differentiate into osteoblasts under the induction of recombinant human bone morphogenetic protein 2 (rhBMP-2).OBJECTIVE: To explore the mineralization reaction during the osteogenic differentiation of myoblasts under the induction of recombinant rhBMP-2 and the feasibility of osteogenic phenotype expression by in vitro induction. METHODS: Myoblasts were isolated and harvested from neonatal Wistar rats using differential velocity adherent technique and trypsinization method. After in vitro culture, purification and identification, myoblasts at passage 3 were induced by a medium containing rhBMP-2 for 21 days. Myoblasts in the control group were cultured in vitro in complete medium without rhBMP-2 for 21 days. RESULTS AND CONCLUSION: After rhBMP-2 induction, myoblast proliferation gradually slowed down. A small quantity of opaque secretory granules were found in the cytoplasm on day 8 after induction; the number of opaque secretory granules increased on day 14 after induction; and a great quantity of opaque secretory granules were found in the cytoplasm on day 21 after induction while the myoblasts without induction fused into contractile myotubes. The alkaline phosphatase activity of the induced myoblasts increased as time extended; myoblasts reacted positively in the alkaline phosphatase staining, immunochemical staining for type Ⅰ collagen and calcium node staining on day 21 after induction. These findings suggest that mineralization reaction is found in rat myoblasts by rhBMP-2 induction and myoblasts can differentiate into osteoblasts under certain inducing conditions in vitro.

Carotid atherosclerosis is one of the important risk factors of ischemic cerebrovascular diseases. Ultrasonography can detect carotid intima-media thickness, compositions, configuration and surface structure of plaque, severity of carotid stenosis and its hemodynamics change, thus it is helpful to estimate the mechanism of ischemia and evaluate its risk factors. So it has a wide application prospect in screening high-risk population, guiding drug administration and surgical intervention.

0.05).[Conclusion]The contents of CRP,IL-1,IL -6,TNF-? are strengthenly expressed within 1 hour and have different expressions in different areas.

Objective To explore CT and MRI appearances of intracranial germinoma.Methods 19 patients with intracranial germinoma confirmed histologically and radiotherapy were selected as the object of this study.CT and MR findings of germinoma were analysed retrospectively.Results Of 19 cases,the tumors were located at pineal region in 12,the basal ganglia and thalamus in 3 and the sellar in 4.Germinoma of pineal region showed low signal intensity on T1WI,iso or hyper-signal intensity on T2WI,isointensity or slightly hyperintensity on CT with definite margin,the pineal calculus were embedded frequently by tumors.After administration of contrast material,the tumors showed marked and uniformity enhancement.Thickness of pituitary stalk and absence of the hyperintensity of the posterior pituitary on T1WI were found in sellar germinoma.Tumors showed iso-signal intensity on T1WI,but variable signal intensity was exhibited on T2WI.Calcification was absent in all cases,but the solid components of tumors were hyperdense on plain CT,and they were obvious enhancement on contrast-enhanced CT scan.Germinoma located at basal ganglia and thalamus showed diffuse growth,larger volum of tumors,inhomogeneous signal intensity and density with indefinite margin,hemorrhage seen in most of case.After administration of contrast material,the tumors showed patch or chaplet-like enhancement.Conclusion It is possible to make the preoperative diagnosis for intracranial germinoma according to sex,age and CT,MR imaging characteristics.

Objective To observe the effects of IL-4 on the expression of epithelial sodium channel(ENaC) ?-subunit.Methods A549 cells were cultured with IL-4 at the concentration of 0,0.1,1 and 10 ng/ml for 12 h or with 1 ng/ml IL-4 for 3,6,12,24 and 48 h.Then ?-ENaC protein and mRNA expressions were detected by Western blotting and RT-PCR respectively.Results IL-4 decreased the expression of ?-ENaC in A549 cells in a time-and dose-dependent manner,via gene transformation.When A549 cells were cultured with IL-4 at the concentration of 1 ng/ml for 3,6,12,24 and 48 h,the expression of ?-ENaC protein and mRNA were decreased in a time-dependent manner.Statistical analysis showed culture for 6 h had a significant difference compared with other time points(P