Objective To explore the influence of earlier nasal continuous positive airway pressure(NCPAP) applying on pulmonary function,and evaluate the clinical results of the early application of NCPAP.Methods Ninety newborn infants with pulmonary dynspnea treated with face mask from Jan.2000 to Nov.2002 were selected as control group.One hundred and ten patients treated with NCPAP from Dec.2002 to Dec.2006 were selected as treatment group.Treatment group applied KD-300 CPAP oxygen therapy equipment NCPAP delivering oxygen.Setting up and adjusting parameter: the beginning flow volume 6-8 L/min,the oxygen therapy bulk(FiO2)30%-50%,the NCPAP pressure was 0.195-0.488 kPa,parameter was adjusted according to the sickness and detecting the transcutancous oxygen saturation(TcSO2).If nasal cannulae Oxygen therapy couldn′t keep the TcSO2 in 85%-93%,the patients in control group were used face mask,small face mask,the oxygen flow vo-lume was 6 L/min,three holes,average FiO2 was 59%.The artery blood oxygen partial pressure [pa(O2)],artery blood carbon dioxide partial pressure [pa(CO2)],oxygenation index(OI),respiration rate(RR) of 2 groups after therapy 4,24 and 72 h were observed,also the difference of recovery rate between the 2 groups were analyzed.Results Compared with the control group,pa(O2) and OI after the application of NCPAP in treatment group were obviously improved(Pa

Objective To investigate the level of alpha-synuclein (α-syn) oligomers in peripheral blood plasma and red blood cells (RBC) in patients with Parkinson's disease (PD), and the value of it for diagnosis and evaluation of PD. Methods From March, 2013 to De-cember, 2014, peripheral blood samples were collected from 30 PD patients and 30 healthy coutrols, and the level ofα-syn oligomers in plas-ma and RBC was detected with enzyme linked immunosorbent assay. Results The level of α-syn oligomers was less in both plasma and RBC in the controls than in the patients (t>2.346, P<0.05), and was more in RBC than in plasma in both the controls and the patients (t>2.242, P<0.05). The level ofα-syn oligomers of patients did not correlate with their course, Hoehn-Yahr Stage, the scores of Unified Parkin-son Disease Rating Scale Part 3, Non-Motor Symptom Quest and Mini-Mental State Examinatlon, both in plasma and RBC (P>0.05). Con-clusion The level ofα-syn oligomers in peripheral RBC and plasma may be helpful for diagnosis of PD, but less for the evaluation of the ill-ness.

OBJECTIVETo investigate a new endoscopic transaxillary technique for release of the sternocleidomastoid (SCM) in congenital muscular torticollis (CMT).

METHODSFrom May 2008 to March 2014, a total of 25 cases (male 7 and female 18), ranging in age from 14 to 31 years (mean age, 17.6 years), were operated for torticollis by endoscopic-assisted surgery. The sternal and clavicular attachments of the sternocleidomastoid were released by skin lift approach.

RESULTSThe primary healing was achieved in all the 25 cases with no injury of major vessels or nerves. The patients were followed up for 6 months with satisfactory result and invisible scar.

CONCLUSIONSThe subcutaneous endoscopic transaxillary and skin lift approach for the CMT provides good functional and cosmetic outcomes.

Adolescent ; Adult ; Axilla ; Cicatrix ; Clavicle ; Endoscopy ; methods ; Female ; Humans ; Male ; Neck Muscles ; surgery ; Torticollis ; congenital ; surgery ; Treatment Outcome ; Young Adult

Objective To evaluate the effects of Prinsepia utilis Royle oil (PURO) on the synthesis of ceramide and expression of acid ceramidase N-acylsphingosine amidohydrolase 1 (ASH1),and to explore the mechanisms underlying its moisturizing and skin barrier-repairing effects.Methods Keratinocytes from human foreskin tissue were classified into 2 groups to be cultured in keratinocyte-serum free medium (K-SFM) with or without the presence of PURO.Enzyme linked immunosorbent assay (ELISA) was performed to measure the level of ceramide in the culture supernatant of keratinocytes at 0,3,8,24 and 48 hours.The back of nude mice was divided into 4 areas,i.e.,test area,matrix area,blank control area and negative control area.Acetone and ether were used to destroy the epidermal barrier in the test,matrix,and blank control areas,then,the former 2 areas were topically treated with emulsions containing 1％ PURO and matrix,respectively,and the blank control area remained untreated.The epidermal barrier remained intact and untreated in the negative control area.Noninvasive methods were used to determine transepidermal water loss (TEWL),epidermal moisture content and skin lipid content in these areas on day 0,1,3,and 7.Skin tissue was obtained from these areas on day 0 and 7 followed by an immunohistochemical study for the quantification of ASH1 expression.Results The level of supernatant ceramide increased with time in the PURO-treated keratinocytes,which was significantly higher at 24 hours and 48 hours than at 0 hour (1.3817 ± 0.100 and 1.3737 ± 0.047 vs.0.7630 ± 0.143,both P ＜ 0.05).The supernatant ceramide was also elevated in the PURO-treated keratinocytes compared with untreated keratinocytes at 24 and 48 hours (both P ＜ 0.05).Noninvasive skin tests showed a gradual decrease in the TEWL,but an increase in the epidermal moisture content and skin lipid content with time in the 3 epidermal barrier-destroyed areas.As far as the test area was concerned,TEWL value was significantly lower on day 3 and 7 than on day 0 (10.85 ± 0.64 and 8.01 ± 0.58 vs.12.65 ± 0.71,both P ＜ 0.05),while a significant increment was observed in the skin lipid content on day 3 and 7 compared with day 0 (29.14 ± 0.40 and 31.30 ± 0.88 vs.27.02 ± 0.65,both P ＜ 0.05),as well as in the epidermal moisture content on day 1,3 and 7 compared with day 0 (13.98 ± 0.28,15.00 ± 0.38 and 15.86 ± 0.18 vs.11.74 ± 0.62,all P＜ 0.05).On day 7,there was a statistical decline in TEWL value,but an elevation in epidermal moisture content,skin lipid content and ASH1 expression in the test area compared with the matrix area and blank control area (all P ＜ 0.05).Also,the expression of ASH1 was upregulated on day 7 compared with day 0 in the 3 barrier-destroyed areas (all P ＜ 0.05).Conclusion PURO may exert skin-moisturizing and barrier-repairing effects by enhancing the synthesis of ceramide and expression of acid ceramidase ASH1.

Objective To investigate the correlation of epidermal distribution of lamellar bodies and expression of ceramidase with skin barrier dysfunction in polymorphous light eruption.Methods Forty-seven patients with polymorphous light eruption and 40 healthy volunteers were recruited into this study.Noninvasive instruments were used to measure skin sebum content,transepidermal water loss(TEWL)and water content in stratum corneum in all of the subjects.Then,tissue specimens were obtained from the lesions at sunexposed sites in the patients and normal skin of the healthy volunteers.The ultrastructure and distribution of lamellar bodies were observed with transmission electron microscopy in five lesion and control specimens.Immunohistochemistry was performed to detect the expression of ceramidase in the tissue specimens.Results Compared with the normal skin from healthy volunteers,the lesions from patients showed decreased number of lamellar bodies in the granular layer and prick cell layer with a disorganized arrangement.Ceramidase was positively expressed in 20 lesion specimens and 36 normal control specimens,weakly expressed in 21 lesion specimens and 4 normal control specimens,and negative in 6 lesion specimens; there was a significant difference in the expression of ceramidase between the lesion specimens and normal control specimens(P ＜ 0.01).The lesions also showed high TEWL(34.2191 ± 12.70 vs.16.8350 ± 6.50,P ＜ 0.01),lower water content in stratum corneum(22.7319 ± 8.71 vs.29.4250 ± 5.08,P ＜ 0.01)and similar skin sebum content compared with the normal skin.Conclusions There is a disturbance in the synthesis of ceramide in patients with polymorphous light eruption,which may contribute to the impairment of skin barrier.

Objective To explore the therapeutic strategy for intracranial ischemia due to extraand intracranial artery stenosis using endovascular stent angioplasty.Methods Totally 109 patients with extra-and/or intracranial artery stenosis were treated by endovascular stent in our hospital from March 2008 to September 2011.There were 93 cases with single stenostic lesion,16 cases with multiple stenosis and 5 cases with distal unruptured aneurysm.All patients received endovascular stentings and 94 cases were followed up for 3 20 months.Results All of the patients underwent endovascular stenting placement successfully.The average stenosises were(79.2 ± 13.4)％ before operation and(18.1 ± 9.20)％ after operation.During follow-up for(10.8 ± 4.2)months,mild restenosis occurred in 9 stenosises(7.0％)among 129 lesions and no serious stroke event was found.Conclusions Endovascular stent is safe and effective in treating extra and intracranial stenosis.It is important to investigate adequately cerebral blood flow in the multiple stenosis or in complicating other kind of vascular diseases before proper treatments.

ObjectiveTo seek experimental evidence of epidermal barrier dysfunction in psoriasis,and to provide a basis for adjuvant therapy of psoriasis.MethodsPhysiometric methods were used to determine the value of sebum content,transepidermal water loss(TEWL) and water content of stratum corneum in 60 patients with psoriasis and 48 normal human controls.The ultrastructure of lamellar bodies was observed with transmission electron microscopy,and the expression of acid ceramidase in normal skin and psoriatic lesions was detected by using immunohistochemical techniques.ResultsCompared with the normal skin,TEWL value was increased(P ＜ 0.01),but water content of stratum corneum decreased(P ＜ 0.01 ) in psoriatic lesions,and sebum content was similar between normal skin and psoriatic lesions.As electron microscopy showed,lamellar bodies in keratinocytes were reduced in number with a disorganized arrangement and irregular size in psoriatic lesions.The expression of acid ceramidase also decreased in psoriatic epidermis.Conclusions The function of epidermal barrier in psoriasis is impaired,and to restore epidermal barrier function and enhance hydration may serve as an important adjuvant therapy of psoriasis.

ObjectiveTo investigate the improvement of speech in patients with increased blood pressure(BP) and stable blood pressure during speech therapy. MethodsAfter monitoring blood pressure with dynamic blood-pressure meter during speech therapy, patients were divided into increased BP group and stable BP group. Patients received two-month speech therapy, then their score changes in ABC examination of pre-treatment and post-treatment were compared. ResultsIn oral expression, score changes in increased BP group were significantly different from those in stable BP group (P<0.05). In listening comprehension, score changes had no significant difference between two groups(P>0.05). Conclusions Patients in increased blood pressure group progressed obviously in oral expression.

BACKGROUND:The authors' experiments of the earlier stage proved that the hypocrellin B photodynamic therapy(HB-PDT) can cause selective injuries to choriocapillaries. It is not known whether changing the therapeutic parameters would gain a different result regarding the choriocapillaries after the hypocrellin B photodynamic treatment for a month.OBJECTIVE: To observe the features of Chinchilla rabbit choriocapillaries after HB-PDT treatment and to probe into the research prospect of using HB-PDT to treat choroidal neovascularization (CNV) and of using green light as the light source for PDT.DESIGN: A single sample study.SETTING: Laser Department of the Chinese PLA General Hospital.MATERIALS: The trial was conducted at the Laser Department and the Department of Pathology of the Chinese PLA General Hospital as well as the Department of Photoelectric Engineering of Beijing University of Science and Engineering. The materials included photosensitizing agent hypocrellin B (HB), a green laser transmitter, fundus fluorescence camera and transmission electronic microscope.METHODS: The 532 nm green laser transmitter and slit-lamp microscope were connected by light fiber. Chinchilla rabbits of 2.5 to 3.5 kg was narcotized generally and HB(1. 0 mg/kg) was injected into the marginal ear vein. HB was excited with the green laser of 532 nm. The power density of the light spot on fundus was 300 mW/cm2, and the energy density 30 J/cm2. Laser was applied immediately after HB injection and the diameter of the light spot was 2 000 μm. Direct observation of retina, fluorescein fundus angiography and observation with light microscope and electronic microscope were conducted on the 1st, 7th and 28th days respectively after PDT to find the biological features of retina and the choroid.MAIN OUTCOME MEASURES: Non-selective injury of retina through direct observation of the fundus; obliteration of the choriocapillaries detected through fluorescein fundus angiography; the position and extent of non-selective injury in retina and the structural changes of the choriocapillaries observed through the light microscope; the ultrastructural changes of the fundus observed through the electronic microscope.RESULTS: One day after PDT, photodynamic thrombosis was formed in choriocapillaries being illuminated and the external layer of retina was apparently injured. On the 7th day, injury of endothelial cells of the choriocapillaries was aggravated without obvious changes of the main vessels of choroid. On the 28th days, fibrous tissue appeared where the choriocapillaries had been and the glass membrane became thickened. Repair and proliferation of RPE cells appeared in the laser illuminated area.CONCLUSION: The biological effect in the target area and non-selective injury in the non-target area began to appear from the 1st to the 7th day after PDT and continued to aggravate. That would be repaired by fibrous tissues from the 28th day. It deserves further studies to treat age-related macular degeneration or other diseases in fundus characterized with choroidal neovascularization.

Objective　To distinguish benign from malignant multiple vertebral collapses.Methods　171 vertebral collapses (77 benign,94 malignancy) were studied in 58 patients with T1WI,T2/T2WI,contrast enhancement T1WI with fat saturation.Pathologic result was available in 16 vertebras,including 10 malignancy and 6 benign.The remaining patients were performed 3～6 months follow-up to confirm the final diagnosis.The following MR characteristics were reviewed:(1)The shape and distribution of abnormal signal intensity.(2)The shape of antero-or poster-border of compressive vertebral body.(3)Paravertebral soft tissue mass.(4)The change of lesions signal intensity on T1WI,T2WI and contrast enhanced MRI with fat saturation.(5)Signal intensity increasing ratio after contrast enhancement.Results　The malignant vertebral compression fractures showed as the punch or patchy low signal intensity on T1WI distributing anywhere in the compressive body and enhancement.It had the convex posterior cortex,pedicle involved,paravertebral soft tissue mass.The benign vertebral compression fractures showed as the band linear hypo-or-iso-intensity in end-plate,enhanced (acute fracture)or unenhanced(old fracture),retropulsion of posterior cortex,no pedicle involved and paravertebral soft tissue.Conclusion　The most important MR characteristics for differentiation of malignant or bengin vertebral compression are the shapes and distributions of the abnormal signal intensities of vertebral collapses.The contrast enhancement T1WI with fat saturation is helpful for imaging diagnosis.