Objective To evaluate two kinds of anterior screw fixations in the treatment of odontoid fractures. Methods A total of 36 patients with D' Alonzo type Ⅱ odontoid process fractures were treated with anterior screw fixation in our department from 1999 to July 2009. There were 28 males and 8 females at mean age of 42.3 years (rang 17-59 years). According to time and surgery procedures, the patients were divided into Group A ( from 1999 to June 2005, n = 11 ) and Group B ( from June 2005 to July 2009, n = 25 ). Patients in Group A received anterior hollow screw fixation of the odontoid process monitored under G-arm or C-arm, while those in Group B received anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system. The operation time and blood loss in two groups were compared by Student' s t test and analyzed with SPSS 13.0 statistical software. X-ray examination was performed in all patients 3, 6 and 12 months after operation to observe fracture union and stability of the upper cervical spine. Results The operation time was ( 102 ± 12) min ( range, 77-148 min) in Group A and ( 104 ± 14) min ( range, 71-150 min) in Group B, with no statistical difference ( P =0.21 ). The blood loss was (465 ± 5) ml (range, 20-130 ml) in Group A and (42 ± 6) ml (range, 26-150 ml) inGroup B, with no statistical difference (P = 0.16). All patients received reexamination three months after operation, which showed no bony union or dislocation but average 40% restriction of neck rotation. One year after operation, 30 patients (83%) got fracture union and six ( 17% ) got fiber healing, with average 24% restriction of neck rotation. Conclusions There is no statistical significant differences between two groups in aspects of operation time, blood loss and fracture healing. But anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system can reduce exposure to radiation of both patients and surgeons. Furthermore, solid screws can be applied to augment the fixation intensity and thereby reduce the complications caused by non - union.

ObjectiveTo observe the clinical effects of mirabilite external application and neostigmine injection at Zusanli acupoint combined with Xuebijing intravenous injection on patients with severe sepsis.Methods A history-prospective controlled study was conducted. Patients with severe sepsis admitted to the Fourth People's Hospital of Jiangsu University from January 2012 to November 2015 were enrolled. Twenty-one cases admitted from January 2014 to November 2015 were assigned as a research group and treated with application of mirabilite external application, Zusanli acupoint injection of neostigmine combined with intravenous Xuebijing injection; 22 patients with Xubijing treatment from January 2012 to November 2015 were included in a Xubijing group; 21 patients with routine therapy from January 2012 to November 2013 were included in a control group. The changes of white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), mean arterial pressure (MAP), oxygenation index (OI), serum creatinine (SCr), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, sequential organ failure assessment (SOFA), gastrointestinal function score, blood platelet count (PLT), plasma prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimmer in three groups before and after treatment were observed; the length of stay in ICU and the 28-day mortality were compared among the three groups. Results Compared with those before treatment, WBC, PCT, CRP, SCr, APACHE Ⅱ score, SOFA score, gastrointestinal function score, APTT, PT, and D-dimer were all obviously lower after treatment for 7 days in various groups; OI, MAP, PLT were significantly higher, and the improvement degree of WBC, PCT, CRP, SCr, APACHE Ⅱ score, SOFA score, gastrointestinal function score, OI in research group was more significant than those of control group and Xubijing group [WBC (×109/L): 7.52±0.75 vs. 12.87±4.13, 10.88±0.66, PCT (μg/L): 1.14±0.55 vs. 6.32±1.39, 3.47±1.94, CRP (mg/L): 21.0±9.2 vs. 65.0±13.6, 35.0±13.9, OI (mmHg, 1 mmHg = 0.133 kPa): 357.0±20.4 vs. 295.0±20.4, 309.0±21.4, SCr (μmol/L): 7.89±2.35 vs. 14.33±9.17, 11.27±4.65, APACHE Ⅱ score: 10.38±0.75 vs. 18.27±2.57, 13.09±4.10, SOFA score: 1.05±0.66 vs. 6.01±2.33, 3.26±1.03, gastrointestinal function score: 0.31±0.11 vs. 2.01±0.46, 1.85±0.29, all P < 0.05], the improvement of PLT, APTT, PT, D-dimer indicators in the research group was more significant than those in control group, but the above improvement compared with that in Xubijing group, no statistically significant difference was found [PLT (×109/L): 220.32±32.44 vs. 105.56±44.03, 170.56±54.03, APTT (s): 30.16±5.23 vs. 39.09±10.11, 29.56±6.85, PT (s): 10.74±1.25 vs. 13.56±4.65, 10.05±1.44, D-dimer (mg/L): 1.13±1.98 vs. 4.03±2.65, 1.13±0.54]. The length of stay in ICU was shortened in research group than that in control group and Xubijing group (days: 13.23±9.45 vs. 25.22±15.46, 18.56±10.33, P < 0.05); the 28-day mortality was significantly lower in the research group than that in the control group [28.6% (6/21) vs. 47.6% (10/21), P < 0.05], but there was no statistically significant difference compared with that in Xubijing group [28.6% (6/21) vs. 31.8% (7/22), P > 0.05]. Conclusions The treatment of mirabilite external application and neostigmine injection at Zusanli acupoint combined with Xuebijing intravenous injection can obviously improve the clinical symptoms, blood coagulation indexes and organ functions, reduce the levels of inflammatory indexes, shorten the time of the length of stay in ICU and elevate the survival rate of patients with severe sepsis.

Objective:To explore therapeutic effect of noninvasive bilevel positive airway pressure ventilation (Bi- PAP)on aged patients with acute left heart failure (ALHF)and evaluation value of NT-proBNP for therapeutic effect in these patients.Methods:A total of 80 aged ALHF patients treated in our hospital were selected.According to random number table,they were equally divided into routine treatment group and BiPAP group (received BiPAP therapy based on routine treatment group ).NT-proBNP level,heart rate (HR),systolic blood pressure (SBP),di- astolic blood pressure (DBP),respiratory rate (RR)and arterial blood gas were compared between two groups be- fore and after treatment.Linear correlation analysis was used to evaluate the correlation among plasma NT-proBNP level and above indexes.Results:There were no significant difference in all indexes between two groups before treatment (P>0.05 all).Compared with before treatment,on 4h after treatment,there were significant reductions in levels of HR,SBP,DBP,RR and NT-proBNP,and significant rise in partial pressure of oxygen in artery (PaO2 ) in both groups (P<0.05 or<0.01),and compared with routine treatment group,there was significant rise in PaO2 [(75.13±19.93)mmHg vs.(85.88±18.47)mmHg],and significant reduction in NT-proBNP level [(3786.71± 1270.38)pg/ml vs.(2658.65±1222.08)pg/ml]in BiPAP group (P<0.05 both).Linear correlation analysis indi- cated that NT-proBNP level was significant positively correlated with HR (r=0.383),SBP (r=0.360),RR (r=0.345)and PaCO2 (r=0.413),and significant inversely correlated with PaO2 (r=-0.471),P<0.05 or<0.01. Conclusion:BiPAP ventilation therapy can improve clinical therapeutic effect in aged ALHF patients,and NT-proB- NP is help to evaluating its therapeutic effects.

Objective To investigate the incidence rate of auditory nerve way injury in children with cerebral palsy (CP) and the relationship with sexes, CP types and risk factors.MethodsThe clinic data of 963 children with CP were reviewed to find out the incidence rate of auditory nerve way injury in CP children and the relationship with sexes, CP types and risk factors.ResultsIn 963 CP children, the incidence rate of auditory nerve way injury was 24.5% (236/963), there was no sexes difference ( P>0.05), but there was a significant difference among different CP types ( P<0.05), athetosis and mixed CP had higher incidence rate ( P<0.01). Furthermore, pathological jaundice was high risk factor ( OR=2.0279, 95%CI:1.483～2.774).ConclusionCP children are often complicated with auditory nerve way injury, it not relate with sexes, but with CP type, athetosis and mixed CP have a higher incidence rate of auditory nerve way injury, and the pathological jaundice is a high risk factors.

Objective To investigate the effects of macrophage inflammatory protein-1α (MIP-1α) combined with molecule 4-1BB L on the tumorigenicity of hepatocellular carcinoma cells in vivo. Methods Mouse MIP-1α (mMIP-1α) expressed Hepa 1-6 cells were transfected with m4-1BBL recombinant retrovirus, the anti-histidinol cells clones were selected and amplified. The expression of m4-1BB L was confirmed by flow cytometry. The growth curve of Hepa 1-6 cells transfected with mMIP-1α and m4-1BBL alone or together was drawn and compared. C57B/L Mice were randomly divided into 7 groups, 9 mice in each group, injected with mMIP-1α+m4-1BB L Hepa 1-6 cells, m4-1BB L Hepa 1-6 cells, mMIP-1α Hepa 1-6 cells, Hepa 1-6 cells, pLXSHD Hepa 1-6 cells or PBS respectively. The tumorigenicity of hepatocellular carcinoma cells and the mice survival rate were compared between each groups. Results Hepa 1-6 mMIP-1α+m4-1BB L cells which expressed both mMIP-1α and m4-1BB L were successfully established. The expression of mMIP-1α and m4-1BB L alone or together did not affect the growth curve of Hepa 1-6 cells. Observed for 5 weeks, no tumor developed in Hepa 1-6 mMIP-1α+m4-1BB L injected mice. The tumorigenicity of Hepa 1-6 mMIP-1α+m4-1BB L was lower than that of Hepa 1-6 mMIP-1α or Hepa 1-6 m4-1BB L in vivo. The survival rate of Hepa 1-6 mMIP-1α+m4-1BBL injected mice(9/9) was higher than that of Hepa 1-6 m4-1BB L injected mice (6/9)or Hepa 1-6 mMIP-1α injected mice (1/9). Conclusion Chemokine MIP-1α combined with costimulatory 4-1BB L lowered the tumorigenicity of hepatocellular carcinoma cells in vivo, and prolonged the mice survival period.

Objective To investigate the clinical characteristics of the results of coronary artery CT angiography and coronary artery angiography in 36 patients with probable positive results of treadmill exercise test(TET).Methods Thirty-six patients due to chest pain received 1ET and coronary artery CT angiography and coronary artery angiography in 2 weeks after admission.The coronary plaques were categorized as noncalcified and calcified plaque on CTA images.Results In 36 patients with probable positive results of TET.23 patients were confirmed as coronary artery disease by coronary artery angiography,and the other 13patients had normal coronary artery.Of 23 coronary artery disease patients,9 patients were presented as onevessel disease,5 patients were presented as two-vessel disease,and 9 patients were presented as three-vessel disease,29 non-calcified plaques and 23 calcified plaques were demeted On CTA.Conclusion TET was useful in confirming the diagnosis of coronary artery disease.The characteristics of the coronary artery plaque is correlated with probable positive results of TET.

Objective: To establish a mouse hepatocellular carcinoma cell line that can produce mMIP-1α and to evaluate the possibility of cancer gene therapy by mMIP-1α. Methods: mMIP-1α cDNA was cloned into retrovirus vector pBabe puro and pBabe puro-mMIP-1α was constructed, then pBabe puro-mMIP-1α was used to transfect packaging cells, anti-puromycin cells was proliferated, the supernatant was used to infect hepa1-6, the anti-puromycin clone (hepa1-6 mMIP-1α) and hepa1-6 were analysed for the expression of mMIP-1α mRNA and protein by RT-PCR and immunohistochemistry respectively. The growth curve of hepa1-6 and hepa1-6 mMIP-1α was drawn. The chemotaxis of mMIP-1α produced by hepa1-6 mMIP-1α to mouse spleen cells was observed on agarose gel. C57B/L mouse was inoculated with the tumor cell and the tumorigenicity was studied. Results: Recombinant retrovirus vector pBabe puro-mMIP-1α with mMIP-1α cDNA was constructed. Hepa1-6 did not produce mMIP-1α mRNA and protein, while hepa1-6 mMIP-1α could produce mMIP-1α mRNA and protein. The growth curve of hepa1-6 and hepa1-6 mMIP-1α showed no difference. The chemotaxis of mMIP-1α produced by hepa1-6 mMIP-1α to mouse spleen cells was observed. The tumorigenicity was reduced. Conclusion: A mouse hepatocellular carcinoma Hepa1-6 mMIP-1α is established and mMIP-1α can affect the tumorigenecity of hepa1-6.

Objective To explore the p27 gene expression and clinical significance in acute leukemia (AL).Methods RT-PCR was used for testing the mRNA levels of p27 gene in bone marrow mononuclear cell of 65 cases of newly diagnosed AL patients and 41 controls.The correlation between the p27 gene expression positive rate and age, sex, peripheral blood white blood cell count and extramedullary infiltration were analyzed simultaneously in AL patients.Results The positive rate of p27 gene expression (36.9 ％,24/65)was significantly lower in AL group than that in the control group (87.8 ％,36/41) (P ＜0.05),and which was lower than the control group (P ＜0.05) in the AML group (34.2 ％,13/38) and the ALL group (37.5 ％,9/24).However,comparing AML group with ALL group,the difference was not statistically significant (P ＞0.05).At the same time,compared the p27 gene expression positive rate of ≥ 14 years old group (52 cases) and ＜14 years old group (13 cases),and also compared in male group (34 cases) and in female group (31 cases),there was no statistically difference (P ＞0.05); Compared the p27 gene expression positive rate of peripheral blood white blood cell count ≥20×109/L group (31 cases) and ＜20×109/L group (34 cases),also compared with in extramedullary infiltration group (37 cases) and in no extramedullary infiltration group (28 cases),the relationship of p27 gene expression positive rate with peripheral blood white blood cell count as well as extramedullary infiltration was a negative correlation (r =-0.284,P ＜ 0.05,r =-0.300,P ＜ 0.05).Conclusion There is p27 mRNA expression deletion in AL patients,and the deletion is present in the AML and ALL at the same time.p27 mRNA expression is negatively correlated with peripheral blood white blood cell count or extramedullary infiltration,which might be one of the mechanisms of occurrence and development of AL.

Objective: To establish a mouse hepatocellular carcinoma cell line that can produce mMIP 1? and to evaluate the possibility of cancer gene therapy by mMIP 1?. Methods: mMIP 1? cDNA was cloned into retrovirus vector pBabe puro and pBabe puro mMIP 1? was constructed, then pBabe puro mMIP 1? was used to transfect packaging cells, anti puromycin cells was proliferated, the supernatant was used to infect hepa1 6, the anti puromycin clone (hepa1 6 mMIP 1?) and hepa1 6 were analysed for the expression of mMIP 1? mRNA and protein by RT PCR and immunohistochemistry respectively. The growth curve of hepa1 6 and hepa1 6 mMIP 1? was drawn. The chemotaxis of mMIP 1? produced by hepa1 6 mMIP 1? to mouse spleen cells was observed on agarose gel. C57B/L mouse was inoculated with the tumor cell and the tumorigenicity was studied. Results: Recombinant retrovirus vector pBabe puro mMIP 1? with mMIP 1? cDNA was constructed. Hepa1 6 did not produce mMIP 1? mRNA and protein, while hepa1 6 mMIP 1? could produce mMIP 1? mRNA and protein. The growth curve of hepa1 6 and hepa1 6 mMIP 1? showed no difference. The chemotaxis of mMIP 1? produced by hepa1 6 mMIP 1? to mouse spleen cells was observed. The tumorigenicity was reduced. Conclusion: A mouse hepatocellular carcinoma Hepa1 6 mMIP 1? is established and mMIP 1? can affect the tumorigenecity of hepa1 6.

Objective To investigate the correlation of PICC tip position and weight gaining in very low birth weight infants.Methods We performed a retrospective study using chest X-ray films of very low birth weight infants in NICU who had PICCs inserted in a tertiary hospital.We recorded the tip positions on plain radiographs and calculated the position change,and calculated weight gaining ratio.Spearman regression model was used to analyze the relationship between tip position migration and weight gaining ratio.Results A total of 57 cases of very low birth weight infants were included,containing 246 X-ray films.On the first day of taking X-ray,weight was 0.6-1.46 (1.06±0.25) kg,the median and interquartile spacing are 5(3,7)d.The last time of taking X-ray was(24.0±9.1) dafter PICC placement;weight gaining ratio was 11.8％～114.8％,the median and interquartile spacing are 41.5％ (27.1％,65.3％).All PICCs tip position changed,75％ of which migrated more than 2 vertebrae,50％ of which migrated 3 vertebrae,and the median and interquartile spacing are 3 (1.8,3.5) vertebrae.The distances of tip migration were correlated with weight gaining ratio.With an approximate 2,3 and 4 vertebrae of PICC tip migration,the corresponding weight gaining ratio was about 40％,70％ and 100％.The correlation coefficient between PICC tip position migration and weight gaining ratio was-0.7(P＜0.01),but there was difference in different insertion sites.Conclusion PICC tip position is greatly influenced by weight gaining among very low birth weight infants.By considering the initial placement position,the crucial moment to assess catheter location is at 40％ and 70％ weight gaining ratio.After 100％ weight gaining,PICCs should be removed or replaced.PICCs can easily be affected by bone growth and limb movement,require higher frequency of catheter localization.