Objective Isoflurane preconditioning has been shown to protect against cerebral ischemia-reperfusion(I/R)injury.The purpose of this study was to investigate if isoflurane inhalation during reperfusion hasany protective effects.Methods Fourty-two SD rats weighing 318-365 g were randomly divided into 3 groups:sham group(n=6),control group(n=18)and isoflurane group(n=18).Control group and isoflurane groupwere further divided into 10,15 and 20 rain ischernia subgroups(subgroup A,B,C,n=6).In isoflurane group1.4% isoflurane in air was inhaled immediately after reperfusion was started for 30 min.Two days before theexperiment the animals were anesthetized with intraperitoneal chloral hydrate 300 mg?kg~(-1).Microdialysis catheterwas inserter into right hippocampns using stereotactic technique and fixed.BIS microelectrodes were placed in thebrain.Vertebral arteries were permanendy occluded by electric coagulation.Bilateral common carotid arteries wereexposed and atranmatic sutures were placed around them.Globol cerebral ischemia was produced by tighteningcarotid sutures and maintained for 10,15 or 20 min(subgroup A,B,C).Cerebral iscbemia was confirmed by lossof righting reflex,dilated pupils,loss of light reflex,BIS=0 and isoelectric potential on EEG.Carotid sutureswere then released for reperfusion.Isoflurane inhalation was started right after the beginning of reperfusion andmaintained for 30 min.Neurologlc outcome was assessed by motor performance according to Combs(0-10,0=severe dysfunction,10=no dysfunction)at 24 h,48 h and 72 h of reperfusion.Microdialysis samples werecollected before during and 0-15,15-30,30-45 and 45-60 min after ischemia for determination of glutamateconcentration.Three days after ischemia the animals were sacrificed and brains were removed for microscopicexamination of hippocampns CA1 region.The number of apoptotic(TUNEL positive)neurons were counted and thepercentage(the number of TUNEL positive neurons/the total number of neurons)was calculated.Results Theglutamate content in hippocampus was significantly lower in isoflurane group than in control group duringreperfusion(P

Objective To estimate the effects of nasal continuous positive airway pressure(nCPAP)therapy on patients with OSAS in prethrombotic state.Methods One group of 30 patients with OSAS who were diagnosed from Sep.2003 to Sep.2005,one healthy control group of 30 cases.Blood samples were taken from people in the supine position in the morning immediately after overnight polysomnography and nCPAP theraphy(only in OSAS group).Results Compared with the normal controls,the level of the molecular marker GMP-140 increased in the blood of patients with OSAS,the levels of APTT,AT-Ⅲ decreased,and the level of t-PA decreased as well.The level of PAI increased.Compared with the healthy controls,datum indicated statistical differences between the two groups.Datum of the patients with OSAS were improved after nCPAP therapy:AHI decreased from 63.21?23.23 to 0.56?0.84;the nocturnal lowest of SaO_2 increased from 0.68?0.07 to 0.90?0.02;GMP-140 and PAI decreased to (17.07?7.97)% and (95.83?5.91)% respectively;AT-Ⅲ and t-PA increased to(95.20?6.67)% and (5.45?1.61)?g respectively.Conclusion Prethrombotic state is present in patients with OSAS.nCPAP therapy can decrease OSAS-related thrombotic complications.

BACKGROUND:Open reduction is general y not advocated for the treatment of children clavicle fracture, because the thick and tough periosteum remains intact and attached by the ligament attachment. In clinic, twin-ring external fixation and simple suspension are commonly used, but there is no reliable basis on which method can get better effect.
OBJECTIVE:To compare the stability of twin-ring external fixation and simple suspension for the treatment of children clavicle fracture.
METHODS:The patients with children clavicle fracture and treated by twin-ring external fixation and simple suspension were selected from June 2008 to December 2012, including 17 patients treated with simple suspension and 22 patients treated with twin-ring external fixation. The X-ray film examination was performed regularly to observe the fracture healing and shoulder function.
RESULTS AND CONCLUSION:The 17 patients treated with simple suspension had good healing;three cases had gap between fracture ends at 1 week after treatment, and re-suspension to increase the height and final y two fracture ends contacted in one case;for the other two cases, there was stil gap between fracture ends, and changed for twin-ring external fixation, the fracture ends contacted. Al the 22 patients in the twin-ring external fixation group obtained healing;five cases had performance of upper extremity neurovascular compression on the fracture side after fixation;after releasing, three cases had recovery, and two cases were treated with simple suspension, the fracture ends began to contact;six cases had armpit redness;four cases had early sleep difficulties;two cases had gap between fracture ends at 1 week after treatment, and after re-adjust, the fracture ends contacted in two cases. The results showed both two methods could not cause appearance deformity, and both could get healing. The simple suspension fixation is easy to operate with reliable effect, and it is comfortable which make it easy to accept by the children, it has the advantages of early for functional exercise, less tissue damage, does not affect the blood supply;the twin-ring external fixation is easy to compress the axil ary arteries and nerves on both sides, thus resulting in upper extremity swel ing, numbness and skin redness, and it can cause discomfort night sleeping and poor comfort which is not easy for children to accept. But, no matter what method we take, the review after 1 week, as wel as the line between proximal and distal part and the contact between fracture ends is stil important.

Background The safety,effectiveness and predictability of laser in situ keratomileusis (LASIK) to correct hyperopia are of a widely clinical concern,but the efficacy of LASIK for hyperopic correction is not satisfied in comparison to that of myopia.Objective The aim of this work was to evaluate the safety,effectiveness and predictability of autologous corneal len inlays to correct hyperopia.Methods Autologous corneal len inlays was performed on the left eye of female patient with the diopter of +3.25 DS.This patient was followed-up for 1 month.Cornea compensatory intraocular pressure (IOPcc) and imitation Goldmann IOP (IOPg) were measured,and the corneal thickness and corneal flap were observed using optical coherence topography (OCT).Corneal topography was examined to check the change of corneal curvature.Ocular response analyzer was used to evaluate the shifts of corneal hysteresis (CH) and corneal resistance factor (CRF).Uncorrected and best corrected visual acuity and refraction were compared between before and after operation.Written informed consent was obtained from the patient prior to the operation.Results No intraoperative and postoperative complications were found.Uncorrected distance visual acuity improved one line 1 day and 1 month after surgery,and near visual acuity progressed to J2 and the spherical equivalent (SE) was-0.125 D 1 month after surgery.OCT exhibited that the cornea was clear and transparent,and the graft was centered in the corneal stroma capsular bag without rejection 1 month after surgery.The IOPcc was 12.4 mmHg before operation and 11.9 mmHg 1 month after operation,and IOPg was 11.9 mmHg before operation and 10.7 mmHg 1 month after operation in the operated eye.The CH was 9.7 mmHg before operation and 8.9 mmHg 1 month after operation,and CRF was 10.9 mmHg before operation and 10.3 mmHg 1 month after operation,without remarkble change in the indexes mentioned above.Conclusions Autologous corneal implantation can be used to correct hyperopic eye with good safety,effectiveness and predictability.

OBJECTIVEDesign and make triple cannula dual-lumen vacuum extractor to improve effect of decompression in operation of intestinal obstruction.

METHODSTriple cannula dual-lumen vacuum extractor was applied in 32 patients who underwent operation of intestinal obstruction from 2012 to 2015 in our hospital. The effect of intestinal decompression and patient prognosis were observed.

RESULTS32 patients that used triple cannula dual-lumen vacuum extractor had good recovery except for one patient abdominal incision with fatty liquefaction. The other patients had one-stage healed without any complication such as intestinal fistula, abdominal infection etc.

CONCLUSIONApplication of triple cannula dual-lumen vacuum extractor in operation for intestinal decompression could avoid contamination of abdomen and injury of intestinal mucosa, which had satisfied effect of intestinal decompression and promoted the effect of operation for intestinal obstruction.

Adolescent ; Adult ; Female ; Hearing Loss, Sudden ; etiology ; psychology ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the expression and significance of Th9, Th17 and CD4+CD25+Foxp3+regulatory T (Treg) cells as well as the related cytokines (IL-9, IL-17, TGF-β) in peripheral blood of patients with adult primary immune thrombocytopenia ( ITP) . Methods Peripheral blood samples were collected from 47 patients with ITP and 39 age-and sex-matched healthy subjects. The percentages of Th9, Th17 and CD4+CD25+Foxp3+Treg cells in peripheral blood samples were detected with flow cytometry. The levels of IL-9, IL-17 and TGF-βin serum samples were detected by enzyme linked immunosorbent assay ( ELISA) . Results Compared with healthy subjects, the percentages of Th9 and Thl7 cells and the concen-trations of IL-9 and IL-17 in patients with ITP were significantly increased [(1. 27±0. 31)% vs (0. 71± 0. 26)%, P<0. 05;(2. 01±0. 42)% vs (0. 97±0. 32)%, P<0. 05. (26. 52±7. 48) ng/L vs (16. 16± 5. 27) ng/L, P<0. 05;(10. 97±3. 94) ng/L vs (7. 14±2. 73) ng/L, P<0. 05]. The percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β in patients with ITP were lower than those in healthy subjects [(4. 69±0. 85)% vs (7. 16±1. 92)%, P<0. 05. (3. 76±1. 28) μg/L vs (6. 41±1. 83)μg/L, P<0. 05]. Moreover, the blood platelet counts in patients with ITP were negatively correlated with the percentages of Th9 and Th17 cells and the concentrations of IL-9 and IL-17 (γs=-0. 349, P=0. 037;γs=-0. 392, P=0. 031;γs=-0. 436, P=0. 014;γs=-0. 401, P=0. 027), but were positively correlated with the percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β (γs=0. 411, P=0. 024;γs=0. 407, P=0. 026). Conclusion The imbalanced distribution of Th9, Th17 and Treg cells and the abnormal expression of related cytokines (IL-9, IL-17 and TGF-β) in patients with ITP might be the possible immunological pathogenesis of ITP.

Aims To establish a UPLC-MS/MS meth-od for the determination of plasma concentration of scutellarein and its metabolite and to study their phar-macokinetics in rat plasma. Methods The analysis was achieved by BEH C18 column with a mobile phase composed of 0 . 1 % formic acid in acetonitrile and 0 . 1% aqueous formic acid using step gradient elution. A TQD tandem mass spectrometry equipped with electros-pray ionization source was used as detector and opera-ted by multiple reaction monitoring( MRM) positive ion mode. After intravenous injection of scutellarein, the concentrations of scutellarein and its major metabolite glucuronide scutellarin in rat plasma were determined at different time points. The pharmacokinetic parame-ters were calculated by DAS 2. 0 software. Results Good linearity was achieved for scutellarein, the ex-traction recovery was between 80 . 5 % to 90 . 5 %, the precisions and accuracy were good. The result showed the pharmacokinetic profiles of scutellarein and glucu-ronide scutellarin both fit to the two-compartment mod-el. Conclusion The above mentioned method is spe-cific, rapid, sensitive and suitable for the pharmacoki-netic studies of scutellarein and its metabolite.

Objective To compare the clinical curative effect of pedicle screw reduction and fix-ation via or not the injured vertebra in treatment of thoracolumbar fractures. Methods A retrospective study was performed on 27 patients with single thoracolumbar fractures admitted from March 2006 to Feb-ruary 2008. There were 12 patients treated with pedicle screw fixation (Group A) and 15 with traditional two-level fixation (Group B). Group A involved 11 males and 5 females, aged average 43 years (25-56 years); Group B included 10 males and 5 females, aged from 23 to 61 years (mean 42 years). All pa-tients had fresh fractures with intact pedicles on either unilateral or bilateral sides. With body position re-duction under anesthesia, the patients in Group B were treated with posterior routine distraction and lordo-sis restoration, while those in Group A were treated with the methods used in Group B as well as pedicle screw reduction and fixation. The kyphosis (Cobb angle) and recovery of injured vertebral height were observed. Results The mean follow-up period was 9 months (6-22 months). After operation, the op-timal Cobb angle and anterior column restoration were achieved through the ventral reduction from the in-jured vertebral body. The degree in anterior movement of injured vertebrae pre- and post-operatively was (0.089±0.036)° in Group A and (0.023±0.048)° in Group B, with statistical difference (P < 0.01). Cobb angle was (9.88±7.69)° in Group A and (5.19±3.24)° in Group B (P < 0.05). Changes of distance between the anterior- upper edge of the cephalad vertebrae to the anterior - lower edge of the caudal vertebral body was (39.3±5.2) % in Group A and (20.6±6.5)% in Group B (P < 0.05). Over distraction of the contiguous discs was also avoided efficiently. Conclusions Selective pedicle screw fixation into the injured vertebrae can help correct the kyphosis and maintain the reduction and en-hance the stiffness of the posterior short-segment instrumentation in single thoracolumbar fractures.

BACKGROUND:Clinical physicians should pay attention on how to reduce ankle fracture healing wounds, reduce bleeding, improve operating technique, and improve repair effect, especialy for comminuted fracture. It is necessary to understand how to develop a detailed plan before repair, observe specific circumstances of the fracture from multiple angles, and establish three-dimensional images using two-dimensional X-ray films or CT scan. These raise a chalenge for each physician. OBJECTIVE:To explore the application effect of three-dimensional print, minimaly invasive percutaneous screw and locking plate fixation in the repair of ankle fractures. METHODS: A total of 26 cases of fracture of ankle joint were treated from January 2012 to June 2014. There were 9 cases of double ankle fracture, 12 cases of three ankle fractures, and 5 cases of three ankle fractures involved PILON fracture on the lower tibia. They received spiral CT scanning on the ankle joint, and stored in the format of di.com. After processing with minics software, data were converted into STL format, and then input into the three-dimensional printer. Thus, models of ankle joint were made at the ratio of 1:1. The repair scheme was made. After discharge, X-ray films were checked every month to observe the healing condition of fractures. According to Mazur ankle score standard, ankle joint function was assessed. RESULTS AND CONCLUSION: Al 26 cases were folowed up for 6-12 months. The fractures were healed. The healing time was 4-6 months, averagely 5.5 months. The healing was good, without vascular and nerve damage, or plate breakage. In accordance with the Mazur ankle score standard, there were excelent in 11 cases, good in 13 cases with an excelent and good rate of 92%. The operation time was (64±15) minutes, and intraoperative blood loss was (100±15) mL. The incision was healed in stage one. These findings confirm that the simulation training and operation in fracture models of three-dimensional print have smal injuries to patients with ankle fracture. The bleeding was less, the operation was simple, the healing time was short, and the functional recovery was rapid, especialy for comminuted fracture.