0.05).Compared with the normal(P0.05).In the control group with G-6-PD deficieney,ROS,MDA of phototherapy of 24 hours were higher,the index of phototherapy was larger significantly than in the the G-6-PD normal.Conclusion Phototherapy can alleviate the ability of anti-oxgenize,it can be more extruding for the patients who are deficient for the G-6-PD by the damage of lipid over oxygenizing,the interference of vitamin E is more efficient.

Objective To investigate the clinical features of acute traumatic subdural hematomas (SDH) in infants and discuss the treatment methods. Methods The clinical features of 48 infants under three years old with acute traumatic SDH admitted from 2002 to 2008 were retrospectively analyzed.Results There were 31 infants under one year old (65%). The most popular injury cause was accidental fall in 37 patients (77%). Of all patients, 12 patients (25%) had disturbance of consciousness,eight ( 17% ) had convulsion and eight ( 17% ) were combined with skull fractures. The treatment methods included craniotomy and evacuation of the blood clot in 18 patients ( including 13 patients underwent instant operation after admission ), burr hole craniotomy and external drainage of the chronic subdural hematoma in seven and conservative management in 23 with small subdural hematomas. All patients obtained good outcome except that two patients had motor dysfunction and one death. Conclusions The incidence of acute traumatic SDH in infants is high, especially in infants under one year old. It is easy to be disregarded at early stage and may deteriorate to chronic subdural hematoma or hydropsy. Early diagnosis and active surgical treatment may attain sound prognosis.

BACKGROUND: Human periodontal ligament fibroblasts (HPLF) is the crucial cells in maintaining the configuration and function of periodontium. Adverse stress may cause HPLF to synthesize more inflammatory agents, which may cause the damage of periodontium.OBJECTIVE: To investigate the role of p38 MAPK of HPLF in the expres sion of inflammatory cytokine of interleukin-6 (IL-6) subjected to mechanical pressure, and explore the mechanism of the occlusal trauma to periodontium.DESIGN: A randomized and controlled trial.SETTING: Pathological Laboratory of the Fourth Military Medical Univer sity of Chinese PLA.MATERIALS: The HPLF were obtained from the middle part of 1/3 pe riodontium of 12 to 16-year-old youth whose 20 healthy permanent premo lar teeth should be extracted for orthodontic need. Main reagents and ap paratus: IL-6 enzyme-linked immunoabsorbent assay (ELISA) kit (Staff Room of Immunology of the Fourth Military Medical University of Chinese PLA); ELISA apparatus (Huadong Electronic Tube Factory); p38 MAPK specific inhibitor of SB203580 (produced by Biochemical Company, ob tained as a present from Professor Jiang, Staff Room of Pathophysiology, Southern Medical University).METHODS: The cells were primarily cultured till the 4-5 passages, and randomly divided into four groups: ①pressure-loading control group: the cell s were not subjected to pressure-loading and without pretreatment; ② pressure-loading group: the cells were subjected to continuous pressure-load ing (200 kPa) but without pretreatment; ③ pretreatment control group: the supernatant were added with 10 g/L dimathyl sulfoxide (DMSO, SB203580 solvent) at 1 hour before pressure-loading, the method and time of pressure loading were the same as those in the pressure-loading group; ④ pretreated group: the cells were pretreated with 1 μmol/L SB203580 (a specific in hibitor of the p38 MAPK) at 1 hour before pressure-loading, the method and time of pressure-loading were the same as those in the pressure-loading group. The cytosol and the supernatant in each group were sampled at 16 and 24 hours after pressure-loading respectively. The IL-6 expressions at different time points were detected with ELISA.MAIN OUTCOME MEASURES: The amount of IL-6 expression in HPLF induced by pressure with or without pretreatment by SB203580, a specific inhibiter of p38 MAPK.RESULTS: The expressions of IL-6 after continuous pressure-loading for 16 and 24 hours in the pressure-loading group were (143.1±0.42) and (49.46±1.01) ng/L, which were obviously higher than those in the pres sure-loading control group [(18.36±0.43), (18.78±0.50) ng/L, P ＜ 0.05]. The expressions of IL-6 after continuous pressure-loading for 16 and 24 hours in the pretreatment group were (56.39±0.72) and (21.52±1.39) ng/L, which were obviously higher than those in the pressure-loading control group [(137.96±0.54), (48.47±0.79) ng/L, P ＜ 0.05].CONCLUSION: p38 MAPK of HPLF acts as important cooperative mechanism to regulate IL-6 synthesis induced by mechanical pressure.

Minimally invasive neurosurgery techniques developing by leaps and bounds in the past few years,which is to be a great challenge for the clinical teaching of neurosurgery.Based on their own actual,neurosurgery department of the Children's hospital of Chongqing medical university enriched the teaching contents,improved teaching methods and trained microsurgical techniques for doctors at various levels,meanwhile,it strengthened participants'sterile awareness,set good team spirit,developed individualized assessment standards and achieved good results.

Objective To assess the role of Matrix Metalloproteinase-9 (MMP-9)in rheumatoid arthritis (RA).Methods Peripheral blood from 45 RA patients and 28 healthy individuals (HV)were collected to detect RF and hs-CRP by immuno-turbidimetry,ESR by westergren method and MMP-9 by ELISA.The correlation was analysed between MMP-9 and RF, ESR or hs-CRP,respectively,by pearson correlation analysis.Results Levels of RF,ESR,hs-CRP and MMP-9 were signifi-cantly higher in RA patients than HV group (t=3.93~5.96,P<0.001),respectively.RF high titer patients or patients with a high inflammation response showed a higher MMP-9 levels than the RF low titer or slight inflammation patients (P<0.05).MMP-9 was positively correlated to RF,ESR and hs-CRP in RA patients(P<0.05),respectively.Conclusion MMP-9 maybe a sensitive tool in the diagnosis and management of RA patients.

Objective To explore the clinical characteristics of posttraumatic cerebral massive infarction in children. Methods 68 cases were reviewed. Results There were 43 cases complicated with subarachnoid hemorrhage, 37 with brain contusion, 48 with fracture of skull,and the hematoma was subdural in 29 cases, epidural in 16 cases, and intracerebral in 14 cases. Other complications included fracture of limbs (24/68), thoracic or abdominal injury (15/68), and hemorrhagic shock (30/68). The infarction were found mostly in the first 7 d (range 2 h~13 d), and 32 cases within 4~7 d after the trauma. The outcome when discharged (according to the Glasgow outcome scale) was good recovery in 32 cases, moderate disability in 15 cases, severe disability in 9 cases, vegetative state in 4 cases, and 8 cases died. Conclusion The feature of the posttraumatic cerebral massive infarction in children is usually concealed by primary injury. CT and MRI are the bases for diagnosis.The outcome may be better than in the adults when early diagnosis and intervention has been produced.

OBJECTIVE: To analyze ultrasonographic finding in fetuses with Wolf-Hirschhorn syndrome (WHS) and refine the critical region on chromosome 4p16.3 for WHS-associated fetal growth retardation (FGR). METHODS: In total 2262 fetuses with abnormal ultrasonographic findings who underwent prenatal karyotyping and chromosomal microarray analysis were reviewed. WHS-associated 4p deletions detected in these fetuses were compared, and prenatal ultrasound findings in such fetuses were summarized. Meanwhile, WHS cases with prenatal ultrasound findings and isolated 4p deletions in previous studies were included for further analysis. An analysis of smallest region of overlap (SRO) among discrepant 4p deletions in these cases above was performed to define a critical region for FGR. RESULTS: 4p deletions were detected in 10 of the 2262 fetuses and 5.0% of the 202 fetuses with FGR. Combined with 80 WHS cases from previous studies, the most common prenatal ultrasound finding was FGR, which yielded a frequency of 76.7%. In addition, a SRO spanning approximately 419 kb (genomic position: 1.32-1.74 Mb) on chromosome 4p16.3 was discovered by comparing the unusual 4p deletions among the 10 fetuses. The region contained seven protein-coding genes, including TACC3, SLBP, TMEM129, FAM53A, MAEA, UVSSA and CRIPAK. CONCLUSION For fetuses with WHS, the most common prenatal ultrasound phenotype was FGR. A region between 1.32 Mb to 1.74 Mb from the telomere on chromosome 4p16.3 is critical for WHS-associated FGR, for which TACC3 and SLBP are the candidate genes.

Objective To compare the value of fractional anisotropy(FA)of MR diffusion tensor imaging(DTI) and Glasgow coma scale(GCS) at admission for judging the injury severity and prognosis of diffuse axonal injury (DAI). Methods Thirty-four patients with DAI adopted the GCS score to evaluate the conscious disturbance levels at admission and conducted the DTI examination within 2 weeks. Twenty-three individuals undergoing healthy physical examination conducted the DTI examination. The FA values of visuality lesion area in various sites,healthy side symmetric site and cerebral midline site were measured. The reduction degree of mean FA value at midline site and visuality lesions were measured. The correlation between GCS score,mean FA value reduction degree in visuality lesions and mean FA value at cerebral midline site with consciousness disorder time and recovery degree in half a year after injury was analyzed. Results The reduction degree of mean FA value at cerebral midline site was significantly correlated with consciousness disorder time and recovery degree in half a year after injury(r= 0. 519,P=0. 002; r= 0. 669, P=0. 000) ;the mean FA value reduction degree in visuality lesions and GCS score had low or weak correlation with consciousness dis order time and recovery degree in half a year after injury(r=0. 285,P=0. 103;r=0. 487,P=0. 003;r= -0. 241,P=0. 169;r=-0. 229,P=0. 192). The correlation between mean FA reduction degree in cerebral midline site and mean FA value reduction degree in visuality lesions with the recovery degree in a half years after injury was higher than that in GCS score. Conclusion DTI is a sensitive sequence for diagnosing DAI and has much more value for judging the injury degree and prognosis than the GCS score generally adopted by clinic.