Objective To explore the operation timing and technique selection of floating knee injury in children.Methods According to Letts types,36 cases were divided into 5 types.The function outcome in every group was compared by Karlstrorm criterion according operation timing or technique selection respectively.Results Thirty-six cases were followed up for an average of 25 months(19 to 84 months).The rate of excellent and good results accounted for 94.12%(16/17) in one stage operation,78.95%(15/19)in stages,60%(6/10)in 2 stages,respectively.Conclusions It may be recommended to treat children with floating knee injury with open reduction intenal fixation or external fixation.The best operation time shall be urgent treatment of both femur and tibia fracture.

Objective To established cardiac-specific transgenic mice of the cTnC D145E and cTnCG159D and compare the HCM and the DCM.Methods The cTnCD145E and cTnCG159D were generated by site-directed mutagenesis and the transgenic plasmids were constructed by insertion of the mutant genes under the control of α-MHC, which is a myocardium specific promoter.The transgenic mice were generated by microinjection and were all maintained on a C57BL/6J genetic backgroud .The cardiac structure and function of the transgenic mice were compared and analysized by echocardiographic and pathological observation at different ages .Results The cTnCD145E and cTnCG159D transgenic mice were established and developed to HCM and DCM, respectively, with aging.The left ventricular end-systolic volume (ESV) and left ventricular end-diastolic volume ( EDV) decreased and ejection fraction ( EF) and left ventricular end-systolic posterior wall thickness (ESPWT) increased in the cTnCD145E transgenic mice, while EDV and ESV increased and EF and ESPWT decreased in the cTnCG159D transgenic mice at 12 months of age.Conclusions Cardiac-specific human cTnCD145E transgenic mice showed HCM phenotypes , and cardiac-specific human cTnC G159D transgenic mice showed DCM phenotypes , which can be used as different models for comparative study of the pathogenesis of cardiomyopathy .

Objective To explore the DNA damage in peripheral blood lymphocytes of rats exposed to sodium arsenite. Methods Thirty-two Wistar rats, weighing 180 - 200 g, equal male and female, were randomly divided into 4 groups, 8 in each group. Sodium arsenite 0(control) ,0.05,0.15,0.45 mg/L were given through drinking water for 30 days. Body weight and drinking water consumption were measured every day. Blood were collected and DNA damage in peripheral blood lymphocytes was examined by single cell gel electrophoresis.Results The increase of body mass[( 121.00 ± 38.57), ( 120.62 ± 42.80), ( 125.38 ± 48.68)g]and water intake [(36.9 ± 6.2), (37.9 ± 5.8), (39.3 ± 4.2)ml/d]in 0.05,0.15,0.45 mg/L sodium arsenite groups were compared with the control group[( 119.25 ± 47.27)g, (38.4 ± 5.1 )ml/d], and the difference were not significant (F = 0.040,0.828, all P ＞ 0.05). The tail ratios[46.25%(185/400) ,57.00%(228/400),64.00%(256/400)], tail lengths [(32.89 ± 17.18), (58.74 ± 36.28), (77.55 ± 35.73 ) μm]and tail moments [(6.29 ± 3.74), ( 11.20 ± 9.64),(17.30 ± 12.60)μm]in 0.05,0.15,0.45 mg/L sodium arsenite groups were significantly higher than those of the control group[39.25%(157/400), (18.73 ± 15.83),(2.61 ± 1.05)μm, all P ＜ 0.01], and the tail ratios,tail lengths and tail moments in lymphocytes increased with increased doses of arsenic concentration. Conclusions Low doses of arsenic exposure can induce DNA damage in peripheral blood lymphocytes of rats.

We applied Lempel-Ziv complexity (LZC) combined with brain electrical activity mapping (BEAM) to study the change of alertness under sleep deprivation in our research. Ten subjects were involved in 36 hours sleep deprivation (SD), during which spontaneous electroencephalogram (EEG) experiments and auditory evoked EEG experiments-Oddball were recorded once every 6 hours. Spontaneous and evoked EEG data were calculated and BEAMs were structured. Results showed that during the 36 hours of SD, alertness could be divided into three stages, i. e. the first 12 hours as the high stage, the middle 12 hours as the rapid decline stage and the last 12 hours as the low stage. During the period SD, LZC of Spontaneous EEG decreased over the whole brain to some extent, but remained consistent with the subjective scales. By BEAMs of event related potential, LZC on frontal cortex decreased, but kept consistent with the behavioral responses. Therefore, LZC can be effective to reflect the change of brain alertness. At the same time LZC could be used as a practical index to monitor real-time alertness because of its simple computation and fast calculation.
Attention ; physiology ; Brain Mapping ; Electroencephalography ; Evoked Potentials ; Humans ; Nonlinear Dynamics ; Sleep Deprivation

Objective To investigate the morphology characters of upper airway and its surrounding tissues in different age non-snoring males.Methods Total of 114 non-snoring males,with age-nlnge from 22 to 78 year old,were included in this study.They were divided into 3 groups:30 in younger group (22-29 years old),57 in middle-aged group(36-57 years old),and 31 in aged group(70-78 years old).All subjects had magnetic resonance imping sanning.Results (1)The nasopharynx in aged group was statistically different from that of the younger group and the midge aged group.The volume of nasopharynx in aged group(7.81±1.59)cm3 (χ-±s,same hereinafter) is greater than that in younger group(4.89±1.20)cm3 and middle aged groups(6.06±2.07)cm3.(2)The AP diameter/transverse dimeter of velophatynx,glossopharynx and laryngopharynx in the aged group tended to be smaller.The average value of AP diameter/transverse diameter of velopharynx in aged group is 0.46±0.14.while the value is 0.59±0.14 and 0.57±0.14 in midge and young groups respectively,compared with that of the aged group,there is statistical diffrence(P＜0.01).Further more,the min/max Section area of velophatynx,glossopharynx,hryngopharynx in aged group are smaller than that of young group and midlife groups.(3)The aged group had the thinnest thickness of posterior and lateral velopharyngeal walls,but the largest volume of soft palate and fatpads among all groups.Conclusions In non-snoring males,there is more fat deposition around the upper airway with aging.While the large naxopharynx and large transvdrse diameter of upper airway seem to balance the disadvantaged changes and to benefit the their sleep respiration.

Objective:To observe the changes of macular microvessels in patients with retinal vein occlusion (RVO) and macular edema (ME) after intravitreal injection of aflibercept (IVA), and analyze its correlation with best corrected visual acuity (BCVA).Methods:A retrospective case study. Thirty patients (30 eyes) with monocular RVO with ME (RVO-ME) who were diagnosed in the clinical examination of Tianjin Eye Hospital from April 2019 to February 2020 were included in the study. Among them, there were 12 males (12 eyes) and 18 females(18 eyes); the average age was 54.30±13.17 years. The average course of disease was3.43±1.97 months. Both eyes were examined by BCVA and optical coherence tomography (OCTA). The on-demand injection was adopted after the first injection in IVA treatment regimen. The macular area 6 mm×6 mm in both eyes was scanned with an OCTA instrument, and the area of the foveal avascular area (FAZ), FAZ circumference (PERIM), and out-of-roundness were measured at baseline and 1, 3, and 6 months after treatment. Index (AI), blood flow density within 300 μm width of FAZ (FD-300), foveal retinal thickness (CMT), superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP) blood flow density. The paired t test was used to compare the quantitative parameters of the affected eye and the contralateral healthy eye at baseline; the changes of the quantitative parameters at baseline and 1, 3, and 6 months after treatment were analyzed by repeated measures analysis of variance. Pearson correlation analysis was used to analyze the correlation between BCVA, retinal perfusion, and macular blood supply parameters at 6 months after IVA treatment. Results:At baseline, compared with the contralateral healthy eye, the FAZ area ( t=-4.091), PERIM ( t=-5.098) and AI ( t=-9.093) of the RVO-ME eye were enlarged, and FD-300 ( t=7.237) and overall SCP and DCP blood flow density ( t=8.735, 9.897) decreased, the difference was statistically significant ( P<0.001). Six months after treatment, the BCVA of RVO-ME eyes was significantly increased, CMT decreased, FAZ area expanded, and AI decreased ( t=8.566, 16.739, -6.469, 9.719; P<0.001), the difference was statistically significant. There was no significant change in the blood flow density of FD-300 and overall SCP and DCP, and the difference was not statistically significant ( t=1.017, 1.197, 0.987; P>0.05). Compared with baseline, the FAZ area of RVO-ME eyes gradually expanded at 3 and 6 months after treatment, and the difference was statistically significant ( F=21.979, P<0.001). Correlation analysis results showed that BCVA at 6 months after treatment was positively correlated with the overall SCP and DCP blood flow density at baseline and 6 months after treatment ( r=-0.538, -0.484, -0.879, -0.854; P<0.05). There was a negative correlation with the area of FAZ 6 months after treatment ( r=0.544, P=0.001). The number of ME recurrences was negatively correlated with BCVA and overall SCP and DCP blood flow density 6 months after treatment ( r=0.604, -0.462, -0.528; P<0.05), it was positively correlated with FAZ area ( r=0.379, P=0.043). Conclusion:Within 6 months of IVA treatment in RVO-ME eyes, ME is significantly reduced and visual acuity is improved; SCP blood flow density decreases, and FAZ area expands.

Objective To compare the efficacy of different target concentrations of sufentanil target-controlled infusion used to supplement topical anesthesia for fiber-optic bronchoscopy (FOB)-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-five ASA physical status Ⅱ or Ⅲ patients with OSAS,aged 28-60 yr,with body mass index of 30-40 kg/m2,scheduled for elective surgery,were randomly assigned into 3 groups (n =15 each):control group (group C) and sufentanil with the target plasma concentration of 0.4 ng/ml (group S1) and 0.6 ng/ml groups (group S2).Naso-pharyngeal and laryngeal mucous membrane was sprayed with 2％ lidocaine mixed with 1％ ephedrine for topical anesthesia in both groups.In addition 1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.FOB-assisted awake nasotracheal intubation was performed after the target concentration was achieved.The degree of airway obstruction was scored during intubation.The highest values of MAP and HR,rate-pressure product ＞ 12 000,decreased respiratory rate and hyoxemia were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The changes in MAP and HR as percent of baseline values were calculated.Before topical anesthesia (T0),when target concentrations were reached (T1),and at 1 and 3 min after intubation (T2,3),blood samples were taken to determine the plasma concentrations of epinephrine (E),norepinephrine (NE) and cortisol.Results Compared with group C,the airway obstruction score was significantly decreased in group S1,the incidence of changes in MAP and HR ＞ 30％ of baseline values and rate-pressure product ＞ 12 000 was decreased,the plasma concentrations of E,NE and cortisol were decreased in S1 and S2 groups,and the incidence of the respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with group S1,the airway obstruction score were significantly decreased,and the incidence of respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with the baseline value at T0,the plasma concentrations of E,NE and cortisol were significantly increased at T2,3 in group C,while decreased at T1 in S1 and S2 groups (P ＜ 0.05).Conclusion Compared with pure topical anesthesia,sufentanil with the target plasma concentration of 0.4 ng/ml does not induce respiratory depression,maintains hemodynamics stable,attenuates the stress responses and provides better intubation conditions when used to supplement topical anesthesia for FOB-assisted awake nasotracheal intubation in patients with OSAS.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of complete vascular ring. Methods Ultrasound images of 6 cases with complete vascular ring were retrospectively analysed and summarized, all cases were confirmed by autopsy after termination of pregnancy. Results Right aortic arch and left ductus arteriosus formed U shaped comlete vascular ring coursing around the trachea in 5 cases, left aortic arch and right aortic arch formed O shaped complete vascular ring in 1 case on three-vessel trachea view. Color Dopple flow imaging aided in identifying various components of the vascular ring. Conclusions Fetal echocardiography is of great clinical value in prenatal diagnosis of complete vascular ring. Three-vessel trachea view is important for screening with particular attention to the relationship of the aortic and duct arches to the trachea.

Objective To observe the month age distribution of peroxisome proliferators activated receptor gamma (PPARγ) expression in rat kedney. Methods Wistar rats aged 3 months,12 months and 24 months were made as models who represented young, middle-aged and old group respectively. Western blotting, immunohistochemical (IHC) and in-situ hybridization (ISH) were used to detect the expression and location of protein and mRNA of PPARγ in rat kidney. Results Western blotting results showed that the expression of PPARγ protein was higher in 3 months group than in 24 months group (0.94±0.05 vs. 0.78±0.02, P＜0.01) and 12 months group (0.87±0.04, P＞0.05), and it reduced in 24 months group than in 12 months group (P＞0.05). By IHC,the PPARγ protein was localized predominantly in the nuclear of tubular epithelia and collecting duct cells in each group. In old age group, PPARγ protein was also detected little in the mesangial and Bowman's capsule epithelial cells. Meanwhile, the distribution of PPARγ mRNA with ISH was consistent with above findings. Additional, semi-quantitative analysis of ISH results verified that the level of PPARγ mRNA decreased with ageing. Conclusions As a nuclear transcription factor,PPARγ participates in the regulation of rat kidney aging.