BACKGROUND: It has been reported that magnesium sulfate(Mg2SO4)treatment has a satisfactory effect on brain ischemia-reperfusion injury, but its effect on spinal cord ischemic injury remains unclear.OBJECTIVE: To evaluate the effects of intravenous administration of Mg2SO4 on spinal cord ischemia-reperfusion injury and further probe into its mechanism.DESIGN: Randomized controlled repeatedly measuring design based on the experimental animals.SETTING: Central research laboratory of a university hospital.MATERIALS: The experiment was conducted in the Central Research Laboratory, Medical College of Xi' an Jiaotong University from April 2003 to June 2004. Twenty-seven New Zealand white rabbits with body mass of 1.9to 2. 5 kg were included. The rabbits were randomly divided into Mg2SO4group, normal saline group and sham-operation group with 9 rabbits in each group.METHODS: The lower segment of the kidney under abdominal aorta was occluded for 30 minutes and 48-hour reperfusion was performed to establish ischemia-reperfusion model of lumbosacral segment of spinal cord. Mg2SO4group (Group A, n = 9) received Mg2SO4 at the dose of 0. 25 mL/kg per hour throughout this procedure; the same volume of saline solution was used in normal saline group(Group B, n=9) . Animals of sham-operation group (Group C, n = 9) were anesthetized and received laparotomy without aortic occlusion. The somatosensory evoked potential(SEP) was detected before ischemia, 30 minutes after ischemia, and 1, 2, 8, 16 and 24 hours after reperfusion. Motor function score was assessed in Mg2SO4 and saline groups 24 and 48 hours after reperfusion. After reperfusion for 48 hours, the animals were killed and histopathological test was performed on the spinal cord.MAIN OUTCOM MEASURES: Motor function score, SEP monitoring and spinal histopathological test.RESULTS: The latency of SEP(Nt) was markedly longer 30 minutes after ischemia in Mg2SO4 group. It was obviously recovered during the first two hours after reperfusion compared with during ischemia, but was obviously prolonged after that. Waveform disappeared 30 minutes after ischemia in normal saline group. SEP amplitudes and latencies in sham-operation group did not change remarkably during the procedures and all the animals recovered without neurological deficits. At each reperfusion time point, the recovery of SEP(N1) latency was better in Group A than that in Group B( P ＜ 0.05). The average motor function score at 24 hours and 48 hours after reperfusion was significantly higher in Group A[ (3.7 ±0.5) and(3.4 ±0.7) points] than that in GroupB [(3.0±0.7) and (2.6±0.9) points](P ＜0.05). The normal nerve cell counting of spinal cord 48 hours after reperfusion in Mg2SO4 group(23. 4 ± 3. 4) was significantly higher than that in saline group (12.3 ±3.2)(P ＜ 0.01).CONCLUSION: Intravenous Mg2SO4 administration may reduce spinal cord injury and preserve neurological function in transient spinal cord ischemia in rabbits.

Objective To observe the effects of intravitreal injection of conbercept for aggressive posterior retinopathy of prematurity (AP-ROP).Methods It is a retrospective case study.Twenty-one patients (40 eyes) with AP-ROP were enrolled in this study.There were 9 males (18 eyes) and 12 females (22 eyes),with the mean gestational age of (28.30±1.79) weeks and the mean birth weight of (1 021.40±316.70) g.All the lesions of 40 eyes were located in posterior zone,with 24 eyes in zone Ⅰ and 16 eyes in zone Ⅱ.All the eyes were treated with intravitreal injection of conbercept 0.025 ml (0.25 mg).During follow-up,nonresponders or patients with deterioration were retreated with intravitreal injection of conbercept or photocoagulation;patients with progressive deterioration to stage 4 had received vitrectomy.At the 1,2,4,8,12,16,20,24 weeks after treatments,the disappearance or decrease of retinal vessel tortuosity and neovascularization,and the growth of the normal retinal vessels toward the peripheral retina were evaluated.Results Thirty-six eyes were cured for only one injection,the cured rate was 90.00％.However,2 eyes (5.00％) had progressed to stage 4 with contractive retinal detachment,which underwent vitrectomy.Two eyes (5.00％) had received twice injections,whose remaining avascular zone area treated by photocoagulation.No major systemic or ocular complications after injection appeared.All lens remained transparent and no iatrogenic retinal hole was occurred during the follow-up.Conclusion Intravitreal injection ofconbercept is effective in the treatment of AP-ROP.

Objective:To explore the influence of trimetazidine (TMZ)combined traditional routine drugs on progno-sis of patients with cardiac syndrome X.Methods:A total of 80 patients with cardiac syndrome X were randomly and equally divided into routine treatment group and TMZ group (received TMZ 20mg,three times/d based on routine medication).Both groups were treated for 12 weeks.Patients of two groups received treadmill exercise test and car-diac function examination before and after treatment,and the results were statistically compared.Results:Com-pared with routine treatment group after treatment,there were significant rise in total exercise time [(7.90±1.45) min vs.(9.35±1.70)min]and the time ST segment depressed 1mm [(5.30±1.43)min vs.(6.78±2.00)min], and significant reduction in ST segment depression extent [(0.89±0.30)mm vs.(0.61±0.20)mm],P <0.05 all;for cardiac function,there were significant rise in stroke volume [(67.99±11.77)ml vs.(74.05±7.58)ml]and left ventricular ejection fraction [(50.13±11.05)% vs.(56.02±9.52)%]in TMZ group,P <0.01 all.Conclusion:TMZ can significantly improve prognosis of patients with cardiac syndrome X.

Objective To observe the effect of Xiaoyukang capsule on the treatment of limb fracture healing.Methods65 patients according to randomized double-blind were divided into two groups (n=33) and control group (n=32 patients), postoperative observation group Xiaoyukang capsule treatment, control group were not special treatment.At different time points in all patients visual analog scale (VAS score), fracture healing fracture line score and grade the degree of X-ray, using Elisa method of total osteocalcin and collagen type I amino-terminal extension of a peptide levels (TPINP) was measured analysis of two sets of data differences.ResultsThe patients in the observation group 3 days, 7 days after, 10 days after VAS scores were lower than the control group[(3.49±0.31) points vs.4.69±0.46 points](P<0.05);[(2.40±0.25) points vs.(3.54±0.35)points](P<0.05);(1.33±0.14) points than (2.42±0.27) points, P<0.05).Patients observed Group 8 weeks, 12 weeks, 16 weeks after the fracture line rates were higher (1.59±0.27 points than (1.01±0.21) points(P<0.05);(2.65±0.40) points than (1.96 ± 0.36)min, P<0.05;(3.45±0.46) points than (2.65 ± 0.41) points(P<0.05).③ patients after 8 weeks of observation group and TPINP water osteocalcin were higher (65.37±8.07)μg/L ratio(39.95±7.18)μg/L(P<0.05);[(81.05±6.89)ng /mL ratio of (39.95±7.18) μg/L] (P<0.05).④ observation group 8 weeks after fracture healing X-ray grade level 69.70% than the control group 37.50%, and the difference was significant (P<0.05).Conclusionlimb fracture patients after taking the capsules Xiaoyu relieve pain, regulate the body and osteocalcin levels TPINP to promote fracture healing.

Objective To analyse the diagnosis and treatment of the single tubular type of diastematomyelia. Methods Clinical scoring and posterior tibial nerve cortical somatosensory evoked potential (PTNCSEP) were performed in 23 cases to define surgical indications and investigate the results of treatment. Results Seven cases without clinical symptoms and 11 cases without progressive neural deficit showed no significant change in terms of clinical scoring and PTNCSEP P40 latent period; while other 5 cases with progressive neural deficit improved after the surgical intervention, and operative findings confirmed that there were fibrous septum or band and other malformations. Conclusion Patients with progressive neural deficit need surgical intervention while those without progressive neural deficit and clinical symptoms only need conservative treatment and routine follow-up.

Objective To explore the effect of single and multiple course dexamethasone on brain development in preterm infants.Met-hods One hundred and eighteen preterm infants delivered after 28-34 weeks′ gestation from Aug.2005 to Mar.2007 in our NICU were enrolled in this study.These infants were divided into 3 groups by antenatalcourses of dexamethasone: control group,single-course group and multi-course group.Supportive treatments were given to all 3 groups.Neonatal behavioral neurological assessment(NBNA) was conducted on expected date of delivery.Mental and psychomotor developmental index was evaluated at 3,6,12 months by using intellectual development table made at Children′s Development Center of China(CDCC).Results The score of NBNA was much higher in single-course group than that in multi-course group and control group(Pa

Infection and inflammatory response can induce the brain damage in neonate,but the mechanism involved in it has not been elucidated completely.Proposed mechanisms include inflammatory response,cytokine and free radical-mediated injury,and excitatory amino acids-induced injury.The activation of microglia and selective vulnerability of immature oligodendrocyte play an important role in the whole process.Recent researches show that the fetal inflammatory response and complex gene regulation are also involved in the infection-induced brain damage.

Objective To characterize the CT and MRI features of Osgood-Schlatter disease (OSD),and explore the feasibility of staging OSD by using CT and MRI.Methods The imaging data of the 27 cases with OSD were retrospectively analyzed,and fea-tures of MRI and CT were characterized.Results All 27 cases with OSD were featured with different extent of edema within the pa-tellar tendon.The portion already exhibited edema in the secondary ossification center in 5 cases,which showed high signal intensity on the T2 WI.There were 1 5 cases which exhibited ossified or tears in the secondary ossification center,and 5 of them were featured with opened shell-like separation on sagittal radiograph.Seven cases had isolated solitary ossicles located at the lower part of the pa-tellar ligament,which is also thickening.Among the 7 cases,one showed hypertrophy in the tibial tuberosity.Three cases examined with CT scan,exhibited ossified nodules located at the lower part of the patellar ligament.Conclusion OSD has characteristic CT and MRI features,and MRI scan is an important imaging method to show edema and morphological changes of patellar tendon in OSD,which could help to identify the stage of OSD and predict the prognosis.

Objective To explore the value of high-resolution MRI(HR-MRI) on clinical application in the differential diagnosis between Moyamoya disease(MMD) and atherosclerosis-related Moyamoya syndrome (A-MMS). Methods Seventeen cases of patients with MMD and 18 cases of patients with A-MMS in our hospital from January 2014 to September 2015 were prospectively enrolled in the study. Record the clinical data and the proximal middle cerebral artery (M1 portion) performance on HR-MRI, the max-vessel area, the min-vessel area, the max-lumen area, the min-lumen area, the wall max-thickness, the styles of M1 portion thickening (eccentric or concentric), whether the wall was enhanced or not, and analysis the recorded data statistically, t test and χ2 test were used for the statistical analysis. Results The wall max-thickness of MMD group was (0.94 ± 0.17) mm, which was smaller than that in A-MMS group (1.23 ± 0.42) mm, there was statistic significance (t=-2.977, P=0.006). The cases of M1 portion non-enhancement was 15, slight enhancement 2, strong enhancement 0 in MMD group, and non-enhancement 5, slight enhancement 5, strong enhancement 8 in the A-MMS group, the difference was significant statistically (χ2=9.794, P=0.001). The cases of M1 portion concentric thickening was 16, 9 cases in the A-MMS group, there was statistic difference between them (χ2=6.317, P=0.012). Wall concentric thickening diagnose the MMD with a sensitivity of 94.1% (16/17), specificity of 50.0% (9/18), accuracy of 71.4%(25/35). Wall strong enhancement appear in the A-MMS with a sensitivity of 44.4%(8/18), specificity of 100%(17/17), accuracy of 71.4%(25/35).With a cut-off the maximum wall thickness of 1.2 mm could be used to noninvasively differential diagnose the MMD and A-MMS with a sensitivity of 55.6%(10/18), specificity of 88.2%(15/17), accuracy of 71.4%(25/35). Conclusion HR-MRI is a good tool for the differential diagnosis between MMD and A-MMS.

Botulism ; therapy ; Child ; Female ; Humans ; Respiration, Artificial