Objective To investigate the treatment method of osteoporotic refracture after vertebroplasty.Methods One hundred and twenty patients (140 vertebraes) with osteoporotic fractures from January 2010 to January 2011 were selected,12 months after operation,15 cases of refracture (20vertebraes) patients as the research object,11 cases were given bone cement to strengthen treatment,postoperative anti-infection,recovery given a positive rehabilitation exercise instruction ;4 cases were given anti-osteoporosis treatment.Follow-up of 10 months,whether leakage of bone cement and the recovery of anti-osteoporosis treatment were observed.Results Eleven patients with refracture in the process of bone cement injection had no prevertebral venous leakage and disc leakage,none of the patients had bone cement leakage after operation;including 3 cases occurred back pain after injection,the main consideration was surgery influenced the local nerve functions and given analgesic treatment,then pain significantly reduced; 4cases with anti-osteoporosis therapy and recoverd better,no pain and other unsuitable symptom occurred.Postoperative 3 d all of the patients could get out of bed,were discharged on 1 week after operation.All patients were not appear the adverse host reaction of fillers,with no occurrence of refracture.Through visual analog pain scale(VAS) score,VAS score in the 3 d after treatment and end-stage follow-up were significantly lower than before treatment [(3.05 ± 0.55),(0.05 ± 0.15) scores vs.(6.95 ± 0.65) scores],and VAS score at the time of end-stage follow-up was lower than 3 d after treatment,there was significant difference (P ＜0.05).Conclusion Bone cement to strengthen with anti-infection and rehabilitation exercise instruction and anti-osteoporosis in the treatment of osteoporotic refracture after vertebroplasty curative effect,safe and reliable effect,worthy of clinical popularization and application.

Objective To research the effect of lysine vitamin B12 oral liquid in treatment ofinfantile anorexia.Methods 130 cases with infantile anorexia admitted from May 2015 to May 2016,which in our hospital pediatric outpatient,were randomly divided into control group and observation group,65 cases in each group.The control group were given routine therapy,including the general treatment,to guide parents to correct the poor eating habits of children and themselves,and given conventional doses of zinc gluconate oral solution according to age.Observation group weregiven lysine vitamin B12 oral solution based on the control group.4 weeks for a course of treatment,of the treatment lasted for three courses.Efficacy,immune function and related adverse reactions were compared between two groups.Results The total effective rate of observation group was significantly higher than that in the control group [93.85％(61/65)vs.(70.77％,46/60)].The difference was statistically significant(P<0.05).The immunological function of the observation group was significantly better than that of the control group,the difference was statistically significant(P<0.05).There was no significant adverse reactions in the two groups.Conclusions Based on the conventional treatment,the effect thatLysine vitamin B12 oral solution on the treatment of children with anorexia was significantly better,which can restore immune function,and application is safety.

Objective To compare suture bridge and single row techniques in repair of rotator cuff tears in a rabbit model.Methods Seventy-six mature male New Zealand white rabbits were used in this study.The 12-month old rabbits,weighing from 2.5 to 3.0 kg (average,2.8 kg),were made models of full-thickness rotator cuff tear by cutting off at the foot print the supraspinatus tendon.The models were randomly divided into 2 even groups (n =38 each).Their right shoulders were repaired by suture bridge and single row techniques respectively in the 2 groups,with their left shoulders untreated as controls.The rabbits were then sacrificed at the 2nd,4th and 8th weeks after surgery for histological comparisons of healing under microscopy.Biomechanical comparisons were made at the 8th week to analyze advantages and disadvantages of the two methods.Results At 2,4 and 8 weeks postoperatively,there were no significant differences between the anterior and middle 1/3 zones of bone-tendon junction regarding cartilage growth or collagen fiber morphology in the suture bridge group,while the cartilage growth and collagen fiber morphology in the middle 1/3 zone of bone-tendon junction were significantly more mature than in the anterior 1/3 zone in the single row group.At the 8th postoperative week,the load to failure in the suture bridge group (134.59 ± 17.69 N) was significantly higher than that in the single row group (72.23 ± 12.08 N) (P ＜ 0.05),but remained significantly lower than that in the control group (192.61 ± 9.42 N) (P ＜ 0.05).Conclusion The suture bridge technique is a feasible and reliable method for repair of rotator cuff tear and has a better healing effect than the single row technique.

Objective To investigate the mecbanism of safflor injection treating myocardial contusion following thoracic impact.Methods Thirty healthy Japan big-ear rabbits were randomly assigned to the myocardial contusion control group (control group,n =15) and safflor injection group (safflor group,n =15).The rabbits with severe myocardial contusion were induced by BIM-Ⅱ Horizontal Bioimpact Machine.Blood samples were taken from common carotid artery of both groups to measure the levels of plasma thromboxance A2 (TXA2) and prostaglandin I2 ( PGI2 ) at 10 minutes before impact and at t0 minutes,30 minutes,1,3,6,12 and 24 hours after impact.Rabbits were dissected to observe the gross and micropathological changes of the hern at 24 hours after impact.Results The control group showed a distinct falling of plasma PGI2 concentration and a significant increase of plasma TXA2 concentration in the early period after severe myocardial contusion.The morphological observation revealed severe myocardial tissue injury as well.However,the safflor group showed insignificant variation pertaining to the reduction of plasma PGI2 concentration and increase of plasma TXA2 concentration,but obvious alleviation of myocardial tissue injury,as compared with the control group.Meanwhile,the ratio of TXB2 to 6- Ketoprostaglandin Fla (6-Keto-PGFla) in the safflor group was lower than that of the control group (P ＜0.05).Conclusion Safflor injection has therapeutic effect on myocardial contusion by elevating the concentration of plasma PGI2 and decreasing the concentration of plasma TXA2 in the early period after severe myocardial contusion.

Objective To investigate the expression and clinical significance of platelet-derived growth factor A (PDGF-A) on placenta tissue from pre-eclampsia.Methods The expression of PDGF-A in the placenta of 38 pre-eclampsia patients and 22 normal pregnant women at third trimester was detected by immunohistochemistry method.Results (1)PDGF-A was mainly expressed in the cytomembrane and cytoplasm of cytotrophoblasts and the endothelial cell of capillary in placenta.(2) The rates of PDGF-A expression of cytotrophoblasts were 63% (24/38) in pre-eclampsia group and 32% (7/22) in normal pregnancy group,which exhibited significant difference (P ＜0.05).(3) The rates of PDGF-A expression of endothelial cell were 68% (26/38) in pre-eclampsia group and 27% (6/22) in normal pregnancy group,which also showed significant difference (P ＜0.01).(4)The rates of PDGF-A expression of cytotrophoblasts were 39% (7/18) in mild pre-eclampsia patients and 85% (17/20) in severe pre-eclampsia,which reached statistical difference (P ＜ 0.01).Conclusion The increasing expression of PDGF-A in cytotrophoblast and endothelial cell in placenta might confer the occurrence and progression of preeclampsia.

Objective To detect the polymorphism of CYP1A1-MspI gene in patients with ovarian cancer.and discuss the relationship between the polymorphism ofCYP1A1-MspI gene and correspond cases' general materials and clinical materials.Methods The free peripheral blood samples of 81 cases confirmed to be ovarian cancer by postoperative pathology were collected preoperatively and the polymorphism of CYP1A1-MspI gene was detected.The clinical materials of the 81 cases with different genotypes were compared.The relationship between the polymorphism and clinical materials was analyzed.Results Among the 81 cases of ovarian cancer,there were 47 cases of wild type-genotype A(T/T)(58%),25 cases of mutation heterozygosis-genotype B(T/C)(31%),and 9 cases of mutation homozygosis-genotype C(C/C)(11%).The genotypic frequency distribution in patients aged from 12 to 29 was one case of genotype A(2.1%),5 cases of genotype B(20.0%),and no case of genotype C.The genotypic frequency distribution in patients aged from 30 to 49 was 12 case of genotype A(25.5%),8 cases of genotype B(32.0%),and 3 cases of genotype C(33.3%).The genotypic frequency distribution in patients aged from 50 to 69 was 31 case of genotype A(66.0%),8 cases of genotype B(32.0%) and 4 cases of genotype C(44.4%).The genotypic frequency distribution in patients aged more than 70 years was 3 case were of genotype A(6.4%),4 cases of genotype B(16.0%),2 case of genotype C(22.2%).There were significant differences of the ages of onset between patients with different CYP1A1-MspI genotypes (P

OBJECTIVE To investigate the bacterial resistance of clinical isolates from pediatric hospital for the guidance of rational use of antibiotics.METHODS Disc diffusion test(Kirby-Bauer method) was used to study the antimicrobial resistance(fastidious bacteria were detected by E test).WHONET5 was applied for analysis.(RESULTS) In the period of study from 2002 to 2003,2 303 strains which were the first isolated from each patient were collected.Of 2 303 clinical isolates,Gram positive organisms accounted for 29.7%,Gram negative ones for 70.3%.Escherichia coli,Klebsiella spp,Staphylococcus aureus,coagulase-negative staphylococci and Pseudomonas aeruginosa were the most common strains among the isolates.Meticillin-resistant S.aureus(MRSA) and meticillin-resistant coagulase(-negative) staphylococci(MRCNS) accounted for 9.7% and 67.6% of S.aureus and coagulase-negative(staphylococci),respectively.Resistant rates of MRSA and MRCNS were higher than that of meticillin-susceptible S.aureus(MSSA) and meticillin-susceptible coagulase-negative staphylococci(MSCNS) to antimicrobial agents commonly used in clinic.No vancomycin resistant strains of staphylococci were found. 4.1% of Enterococcus spp were vancomycin resistant strains.Resistant rate of Streptococcus pneumoniae was 11.9% to penicillin. Most of isolates of Enterobacteriaceae were susceptible to imipenem.The incidences of E.coli and Klebsiella spp producing extended spectrum beta-lactamases(ESBLs) isolates were 49.7% and 63.1%,respectively.The resistance rates of(ESBLs) producing strains to antimicrobial agents(except carbapenems) were higher than those of ESBLs nonproducing ones.CONCLUSIONS Bacterial resistance is still or even a more serious clinical problem than before.The(surveillance) of antimicrobial susceptibility in pediatric hospital is of great significance.It is also very important to promote the rational use of antimicrobial agents so that resistance is minimized and take effective strategy for the control of the problem.

Objective: To explore the occurrence rate of permanent pacemaker implantation (PPI) with relevant risk factors in patients after mechanical aortic valve replacement. Methods: A total of 1986 consecutive patients with mechanical aortic valve replacement were enrolled in this study. According to PPI conduction caused by severe arrhythmia , the patients were divided into 2 groups: PPI group,n=61 including 27 male with the average age of (53.6 ± 9.03) years and Non-PPI group,n=1925. The median follow-up time was (4.47 ± 4.36) years after valve replacement. Results: The patients in PPI group were with the elder age and higher ratio of pre-existing atrial ifbrillation (AF) than those in Non-PPI group,P<0.05. The overall PPI occurrence rate was 3.07% after valve replacement and the short term incidence rate (within 30 days) was 0.55%, midterm (from 30 day to 1 year) was 0.03%, long term (>1 year) was 2.22%. For PPI indications, there were 70.5% patients with high degree A-V block including 30 of AF combining long intervals, 12 of high degree A-V block, 1 of complete left bundle branch block (LBBB) and 14.8% patients with sick sinus syndrome/sinus arrest/ sinus bradycardia. Conclusion: PPI incidence was at a relative low level, the long term occurrence rate was higher than both short term and midterm; elder age, pre-existing AF could be the high risk factors for PPI requirement, and the major PPI indication was high degree AV block in clinical practice.

Objective To evaluate the cardiac function in patients with chronic obstructive pulmonary disease ( COPD) by using echocardiography.Methods Three hundred and twenty eight COPD patients and 60 age and gender-matched healthy subjects ( control group ) were enrolled in the study. According to Global Initiative for Chronic Obstructive Lung Disease ( GOLD ) criteria, patients were as classified as mild (n=102), moderate (n=85), severe (n=80) and very severe (61).All participants underwent conventional echocardiography and two dimensional-speckle tracking echocardiography (2D-STE) to assess cardiac function.Results The LVEF was reduced significantly, while the PASP was increased in severe and very severe COPD patients [(60.9 ±2.0)% and (59.4 ±2.8)%, t value:3.358, 4.859 to normal controls, 5.247, 6.641 to mild, 3.280, 4.863 to moderate, respectively, all P<0.001].The LA size was dilated in very severe COPD patients [(3.9 ±0.5) cm, t value: -2.407, -2.625, -2.071,-2.186, P<0.05 ] , and the RVEF was significantly less than those of the other patients [ ( 42.8 ± 7.3)%,t value: 6.357, 6.832, 5.581, 4.639, P<0.05 ] .The right ventricular FAC of moderate or severe COPD patients and the segmental and global LS of left and right ventricular in COPD patients were significantly lower than those in the normal controls, and which were gradually decreased as GOLD classification rising [ RVFAC, moderate: ( 37.7 ±2.0 )%, severe: ( 35.5 ±3.2 ) %, very severe:(34.0 ±3.1) %, t value: -4.616, -5.982, -7.195, respectively; LSLVg, moderate: ( -18.62 ± 1.76) %, severe: ( -17.15 ±0.73 ) %, very severe: ( -16.51 ±0.89 ) %, t value: -9.389,-15.494, -16.873, respectively;LSRVg, moderate:(-20.52 ±2.27) %, severe:(-18.84 ±1.38)%, very severe:(-16.82 ±1.10) %, t value:-8.555, -13.595, -18.499, respectively, all P<0.001].Besides, the FAC of COPD patients was positively correlated with the RVEF (r =0.676,P <0.05), while the RVLSg was negatively correlated with the FAC and RVEF (r=-0.677, -0.591,all P<0.05) .Conclusions There were left and right ventricular dysfunction in COPD patients, which decreased as GOLD classification upgraded. The FAC and 2D-STE can effectively detect the subtle abnormalities of regional and global ventricular function.

Objective To investigate the molecular characteristic,the virulence factors and antimicrobial resistance of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from pediatric patients.Methods Ninety-eight non-duplicate strains of and 49 non-duplicate strains of Methicillinsusceptible Staphylococcus aureus (MSSA) isolated from the three children's hospitals in Shanghai in 2008 were investigated.Panton-valentine leukocidin (PVL) gene was detected by polymerase chain reaction (PCR).The genotypes of staphylococcal cassette chromosome mec (SCCmec) of the MRSA isolates were confirmed by multiplex PCR.The sequence type (ST) of each strain was determined by multilocus sequence typing (MLST),and the algorithm eBURST was used to identify groups of clonal complex (CC).The minimal inhibitory concentrations (MIC) of fourteen antibiotics for all isolates were determined by agar dilution method.Results Among 98 isolates of MRSA,the positive rate of PVL genes was 6.1％ (6/98).In contrast,the positive rate of PVL genes was 4.1％ (2/48) of the MSSA strains.Among 98 isolates of MRSA,4.1％ (4/98),23.5％ (23/98),53.0％ (52/98) and 15.3％ (15/98) of the strains harboured SCCmec types Ⅱ,Ⅲ,Ⅳ and Ⅴ,respectively. The remaining four isolates (4.1 ％) presented a unique SCCmec pattern that could not be classified to any known types by the employed typing assays.Combining the ST and SCCmec type,the predominant clones were ST59-SCCmec Ⅳ (30 strains) and ST239-SCCmec Ⅲ (23 strains),followed by ST5-SCCmecⅣ and ST1-SCCmecⅣ (8 strains for each clone),ST239-SCCmec Ⅴ (6 strains),ST88-SCCmecⅤ (5 strains),ST5 SCCmecⅡ (4 strains),ST59-SCCmec Ⅴ (3 strains),ST8-SCCmecⅣ and ST88-SCCmecⅣ (2 strains for each clone),ST22-SCCmecⅣ,ST910-SCCmecⅣ and S45-SCCmec Ⅴ (1 strain for each clone),eBURST analysis distributed the MRSA isolates into several CC.ST8 and ST239 belonged to ST8 CC,ST1 belonged to ST15 CC,ST910 belonged to ST 30 CC,ST59,ST5,ST88,ST45,ST22,ST9 and ST7 were the origin of their own CC.The results of MIC showed that the 67 strains of MRSA harboring SCCmec type Ⅳ or SCCmec type Ⅴ were more susceptible to various non-β-lactam antibiotics than 27 strains of MRSA harboring SCCmec type Ⅱ or SCCmec type Ⅲ,and no vancomycin-resistant strain was found.Conclusions In three children's hospitals in Shanghai,the PVL gene-positive rate of MRSA isolates is relatively low,SCCmec type Ⅳ and SCCmec type Ⅴ could spread among hospitals to cause a small scale epidemic and have a variety of ST.