This article introduces the general concepts and methods of sample size estimation and testing power analysis. It focuses on parametric methods of sample size estimation, including sample size estimation of estimating the population mean and the population probability. It also provides estimation formulas and introduces how to realize sample size estimation manually and by SAS software.

Objective To investigate the present status of casualty epidemiology in Zhengzhou and the effects of different trauma care model.Method Statistic study of the classification of emergency disease and the number of ambulance responses to the call in Zhengzhou emergency rescue center from January,2004 through December 2006 was carried out and the efficiency between the trauma care model of an inclusive emergency rescue survices station and that of a simple emergency survices station was analyzed.Results The percentage of ambulance departure responses by Zbengzhou emergency rescue center for trauma care was 45.3 %,44.7 % and 45.8% of in 2004,2005 and 2006,respectively.There were 26 emergency rescue service stationa in Zhengzhou, including one independent station,eight internal medicine dominated semi-independent stations and seventeen simple model stations.The indicated surgical intervention can lye performed on the patients with severe multi- trauma in the independent emergency station in order to win the optimal operation time and reduce the mortality. Conclusions The trauma is the major reason for the emergency call.Emergency rescue service stations properly distrihtted,can offer quick and efficient pro-hospital first aid.The independent emergency rescue service station can increase successful resuscitation rate of serious casualties.

Objective To investigate the expression of Foxp3~+ lymphocytes in breast carcinoma tissues and their correlation with other pathological factors,and to investigate the mechanism of action of Treg cells.Methods The expression of Foxp3~+ lymphocytes in the breast cancer tissue and non-cancerous tissue was detected by flow cytometry (FCM) in 30 breast carcinoma patients, and its correlation with other pathological factors was statistically analyzed by multiple linear regression analysis.The expression of TGF-β and IL-10 in the lymphocytes infiltrated in breast cancer tissue and non-cancerous tissue was measured by immunohistochemistry, and their correlation with the expression of Foxp3~+ lymphocytes was statistically analyzed by linear correlation dependability analysis. Results There was significant difference in the expression of Foxp3~+ lymphocytes between the malignant and non-cancerous breast tissues(P<0.05),and it was positively correlated with the clinical stage,blood vessel invasion and the matter of axillary lymph node metastasis(P<0.05). The expression of IL-10 in the tumor infiltrating lymphocytes was positively correlated with the expression of Foxp3~+ lymphocytes(P<0.05).Conclusion The expression level of Foxp3~+ lymphocytes is correlated with invasion and metastasis of breast carcinoma, and the IL-10 secreted by Foxp3~+ lymphocytes may be involved in this effect.Foxp3~+ lymphocytes can be used as an assistant marker for prediction and new therpeutic target of breast cancer.

Objective:Matrix metalloproteinases7(MMP7)is reported to be involved in the invasion and metastasis of some human tumors.In this study ,we investigated the role of MMP7 in human panereatic careinoma(PC)progression.Materials and Methods:A total of 51 cases of PC,including 22 early lesions(clinical stage Ⅰ and Ⅱ)and 29 of advanced ones(clinical stageⅢ and Ⅳ),were tested for MMP7 expression using immunostaining assay.Results:Increased MMP7 immunoreactivity was present in 35(68.6%)cases of PC,and frequently distributed in the invasive front of the tumors.More cases expressed positive MMP7 in advanced group(23/29,79.3%)than in early group(12/22,54.5%;P<0.05).Conclusion:The increased expression of MMP7 was related to PC progression and might be considered to be useful as a marker for biological aggressiveness of this malignancy.

OBJECTIVETo evaluate the clinical efficacy of mini-open repair for the treatment of acute closed achilles tendon ruptures.

METHODSFrom April 2012 and October 2013,14 patients (14 feet) with acute closed achilles tendon ruptures were treated in our department. They were 9 males and 5 females, with an average age of 30.5 years old (ranged, 25 to 49 years old). The interval between injury and operation ranged from 1 to 13 days (8 days on average). A longitudinal incision approximately 1.5 to 2.0 cm in length was made around the ruptured achilles tendon for mini-open repair after insertion of oval clamp. Postoperative rehabilitation was carried out.

RESULTSThe wounds healed at the first stage except 2 cases with slow recovery. All the patients were followed up for 6 to 24 months, with an average of 11 months. According to the ankle-hindfoot scoring system of American Orthopaedic Foot & Ankle Society (AOFAS),the score was 92.71 ± 6.58 (82 to 100).

CONCLUSIONThe surgical treatment of acute achilles tendon rupture with mini-open repair has advantages of little invasion, a low rate of incision problems, quick function recovery, and simple operation, and it is suitable for primary hospital.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adult ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tendon Injuries ; physiopathology ; surgery ; Treatment Outcome ; Wound Healing

OBJECTIVE:To establish a method for simultaneous determination of tanshinol,caffeic acid,rosmarinic,salviano-lic acid B,salvianolic acid A,tanshinoneⅠ,cryptotanshinone,tanshinone ⅡA and ursolic acid in Compound xueshuantong cap-sules. METHODS:UPLC-MS/MS method was adopted. The determination was performed on ACQUITY UPLC? BEH C18 column with mobile phase consisted of acetonitrile-0.1%formic acid(gradient elution)at the flow rate of 0.2 mL/min. The column tempera-ture was 40 ℃,and the temperature of injector was 10 ℃. Analysis time was 7 min,and sample size was 5 μL. The electrospray ionization source(ESI)was used;ion source temperature was 150℃;capillary voltage was 3.5 kV;cone flow was 50 L/h;desol-vation temperature was 350 ℃;desolvation gas flow was 650 L/h;nebuliser pressure was 7 × 105 Pa;ion monitoring and multiple reaction monitoring (MRM) was performed. RESULTS:The linear ranges of tanshinol,caffeic acid,rosmarinic,salvianolic acid B,salvianolic acid A,tanshinoneⅠ,cryptotanshinone,tanshinone ⅡA and ursolic acid were 10.0-100.0 μg/mL (r=0.9998), 0.1-1.0 μg/mL(r=0.9998),4.0-40.0 μg/mL(r=0.9999),10.0-100.0 μg/mL(r=0.9999),15.0-150.0 μg/mL(r=0.9997), 8.0-80.0 μg/mL(r=0.9998),10.0-100.0 μg/mL(r=0.9997),50.0-500.0 μg/mL(r=0.9997)and 6.0-60.0 μg/mL(r=0.9998), respectively. The limits of quantitation were 40.0,9.6,38.0,88.0,130.0,39.0,4.4,3.2 and 10.0 ng/mL,separately. The limits of detection were 12.0,3.0,11.0,26.0,39.0,12.0,1.3,1.0 and 3.0 ng/mL,respectively. RSDs of precision,stability and repro-ducibility tests were all lower than 3%. The recoveries were 97.34%-103.20%(RSD=2.19%,n=6),97.22%-102.39%(RSD=2.03%,n=6),98.51%-101.70%(RSD=1.32%,n=6),97.86%-102.49%(RSD=2.09%,n=6),96.75%-103.12%(RSD=2.36%,n=6),98.43%-101.65%(RSD=1.25%,n=6), 97.59%-101.50%(RSD=1.50%,n=6), 96.45%-102.88%(RSD=2.58%,n=6),97.02%-103.11%(RSD=2.38%,n=6),separately. CONCLUSIONS:The method is simple and accurate,and can be used for simultaneous determination of 9 components in Compound xueshuantong capsules.

The change of kirenol, darutigenol and darutoside in Siegesbeckia and its first to ninth processed products were studied, and the ten fingerprints were compared, which provided the experimental basis for the study of Siegesbeckia processing tech- nology. The samples were analysed by HPLC on a SunFire-C18 column (4.6 mm x 150 mm, 5 μm) with gradient elution of acetonitrile (0.1% formic acid)-water (0.1% formic acid) at a flow rate of 1.0 mL x min(-1). Column temperaturewas 30 °C and the detected wavelength was 215, 320 nm. The calibration curves of kirenol, darutigenol and darutoside were linear in the range of 2.180-26.16, 2.900-34.80, and 1.012-6.072 mg x L(-1), respectively, and the average recoveries were 96.4%, 97.2% and 96.3% wit RSD 2.2%, 1.7% and 2.4%. This method was simple, the result was stable and had good repeatability, recovery and precision. The re- sult was the basis of the chemical contents variation in the processing of Siegesbeckia Herbs and further clarifying the effect of the changing.
Asteraceae ; chemistry ; Chemistry, Pharmaceutical ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Temperature

Background The effect of chronic stress on cognitive functions has been one of the hot topic in neuroscience. But there has been much controversy over its mechanism. Such single stressor applied in the past could not simulate complicated living circumstances that people confronted with. The aim of this study was to investigate the effects of chronic multiple-stress on learning and memory as well as on the levels of calcium/calmodulin-dependent protein kinase II (CaMKII), calmodulin (CaM) mRNA, and cAMP-response element binding protein (CREB) mRNA in the hippocampus of rats. Methods The rats were divided randomly into stressed and control groups. The stressed group was given chronic multiple-stress for 6 weeks to set up a chronic multiple-stressed model. The rats' performance of spatial learning and memory was tested using Morris Water Maze (MWM) and Y-maze. Meanwhile, the expressions of CaMKII, CaM mRNA and CREB mRNA of rats' hippocampus were detected by immunohistochemistry, Western blot and reverse transcription-polymerase chain reaction (RT-PCR), respectively. In addition, the width of synaptic cleft and the thickness of post-synaptic densities (PSD) were observed in the hippocampal CA3 region of rats by electron microscopy. Results After exposure to chronic multiple-stress for 6 weeks, the ability of learning and memory of the stressed group was higher than that of the control group (P<0.05, P<0.01). The width of synaptic cleft was smaller and the thickness of PSD was larger in the hippocampal CA3 region of the stressed group than in that of the control group (P<0.01). The CaMKII immunostaining of the stressed group was stronger than that of the control group in the stratum radiatum and oriens of the hippocampal CA1 and CA3, especially in the stratum oriens. Quantitative analysis indicated that the expression of CaMKII, CaM mRNA, and CREB mRNA in the hippocampus of the stressed group was higher than that of the control group (P<0.05, P<0.01). Conclusions The capacity of learning and memory can be enhanced after chronic multiple-stress. The increased levels of CaMKII, CaM mRNA, and CREB mRNA may contribute to the enhancing effect of chronic multiple-stress on learning and memory.

BACKGROUNDPercutaneous vertebroplasty (PVP) has become a popular procedure for painful vertebral osteoporotic fracture (VOF), with immediate pain relief and improved mobility; however, polymethylmethacrylate (PMMA) injected into the vertebral body is not absorbable and little information is available concerning the long-term results. In this retrospective study, we evaluated the long-term clinical results and radiological changes after PVPs for VOFs.

METHODSFifty-one patients with VOFs were treated by PVPs with PMMA between 2000 and 2004. After > 7 years of follow-up, eight patients had died from causes unrelated to the intervention and 12 patients were lost to follow-up, thus leaving 31 patients available for evaluation with an average length of follow-up of 9.2 years (follow-up rate, 72.1%). Among these 31 patients, the PMMA was injected at 43 levels with a mean volume of 4.3 ml per level (range, 2 - 6 ml). The pain was assessed with a visual analog scale (VAS), and the mobility was graded as walking without difficulty (grade 1), walking with assistance (grade 2), and bedridden (grade 3). Plain radiographs and computed tomography (CT) were obtained and assessed pre-operatively, immediately post-operatively, and after 7 years of follow-up. The PMMA, vertebral height, and Cobb angle were assessed and compared.

RESULTSAll of the patients experienced pain relief and improved mobility after intervention and during the follow-up period. Cement leakage was detected in post-operative CT scans in 9 of 51 patients, but without neurological compromise. For the 31 patients followed up over 7 years, the VAS decreased from 8.3 ± 2.6 pre-operatively, to 2.1 ± 1.6 immediately post-operatively, and 1.0 ± 0.9 at the final follow-up evaluation, with significantly improved mobility. Additional compression fractures occurred at adjacent levels in three patients, and there were no new fractures at the augmented vertebrae. Based on a review of the radiographs, neither loose nor displaced cement was detected. The changes in vertebral height and Cobb angle were not significant. On CT scans, the cement closely contacted or infiltrated the trabecular bone. The boundary between the cement and trabecular bone was indistinct and there was no evident radiolucent gap between the cement and trabecular bone.

CONCLUSIONSAt an average follow-up of 9.2 years, PVPs provided sustained pain relief and improved mobility in patients with VOFs. The PMMA injected into the vertebral body combined closely with the host trabecular bone without adverse reactions.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Polymethyl Methacrylate ; therapeutic use ; Retrospective Studies ; Spinal Fractures ; surgery ; Vertebroplasty ; methods

OBJECTIVETo assess the differences in peritoneal microstructure injury between laparoscopic and open radical resection for colorectal cancer.

METHODSA total of 50 patients with colorectal cancer were consecutively assigned into laparoscopic group (LO, n=27) and conventional laparotomy group (CO, n=23). Prospectively comparative analyses of operative time, intraoperative blood loss, number of lymph node harvest, positive rate of lymph nodes, length of specimen and resection margin involvement were performed. Optical microscope and scanning electron microscope were used to detect postoperative peritoneal injury between patients who received laparoscopic surgery or open surgery.

RESULTSCompared with the CO group, operative time [(150.6+/-39.5) min vs (183.0+/-39.2) min, P<0.05] and intraoperative blood loss [(80.0+/-75.2) ml vs (234.5+/-235.3) ml, P<0.01] were significantly less in the LO group. No significant differences were found between two groups in length specimen, number of lymph nodes harvest, positive rate of lymph nodes, and all resection margins were negative (P>0.05). Optical microscope indicated less serosal injury in the LO group as compared to the CO group with regard to serosal integrity, continuity of covering adipocyte and mesothelial cell, and the aggregation level of erythrocytes and inflammatory cells (P<0.01). Scanning electronic microscopy showed more severe injury to colorectal serosa, mesothelium and basement membrane in the CO group as compared to the LO group.

CONCLUSIONWith equal degree of radical resection, laparoscopic technique for colorectal cancer causes less peritoneal structural injury as compared with open surgery.

Aged ; Colorectal Neoplasms ; pathology ; surgery ; Female ; Humans ; Laparoscopy ; adverse effects ; Laparotomy ; adverse effects ; Male ; Middle Aged ; Peritoneum ; injuries ; pathology ; Prospective Studies ; Single-Blind Method